Efficacy of Low-Dose Aspirin for the Prevention of Pre-eclampsia in High-Risk Nulliparous Pregnant Women

International Journal of Medicine and Medical Sciences | Vol. 11, No. 10, October 2021 | pp. 73–80

DOI: 10.46882/2021/IJMMS/110073

Original Research Article

Efficacy of Low-Dose Aspirin for the Prevention of Pre-eclampsia in High-Risk Nulliparous Pregnant Women

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

Pre-eclampsia remains a major cause of maternal and perinatal morbidity worldwide, highlighting the need for effective preventative strategies in high-risk populations. This randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy and safety of low-dose aspirin in preventing pre-eclampsia among high-risk nulliparous pregnant women. A total of 220 nulliparous women identified as high-risk (due to pre-existing chronic hypertension, pre-gestational diabetes, or an elevated uterine artery pulsatility index on ultrasound) were randomized between 12 and 16 weeks of gestation. Participants received either daily low-dose aspirin (81 mg, n = 110) or a matching placebo (n = 110) until 36 weeks of gestation or delivery. The primary outcome was the incidence of pre-eclampsia, while secondary outcomes included gestational age at delivery, birth weight, and adverse bleeding events. The incidence of pre-eclampsia was significantly lower in the aspirin group (7.3%, 8/110) compared to the placebo group (17.3%, 19/110; p < 0.05; Relative Risk = 0.42, 95% CI = 0.19–0.92). Additionally, the mean gestational age at delivery was significantly higher in the aspirin cohort (38.2 ± 1.4 weeks) than in the placebo cohort (37.1 ± 2.1 weeks, p < 0.01). The incidence of low birth weight infants (< 2,500 g) was also lower in the aspirin arm (9.1% vs. 20.0%, p < 0.05). There were no significant differences between the two groups regarding postpartum hemorrhage or abruptio placentae (p > 0.05). Early initiation of low-dose aspirin significantly reduces the incidence of pre-eclampsia and improves neonatal outcomes in high-risk nulliparous women without increasing bleeding risks.

Keywords: Pre-eclampsia, Low-Dose Aspirin, Nulliparous, High-Risk Pregnancy, Gestational Age, Birth Weight

Manuscript Timeline: Received: June 18, 2021; Revised: July 30, 2021; Accepted: August 24, 2021; Published: October 15, 2021.

Citation: Bello FZ, Mensah KA, Ojo GN. Efficacy of Low-Dose Aspirin for the Prevention of Pre-eclampsia in High-Risk Nulliparous Pregnant Women. International Journal of Medicine and Medical Sciences, 2021, 11(10): 73–80. DOI: 10.46882/2021/IJMMS/110073

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