(161) Effectiveness of Low Dose Aspirin for Prevention of Preeclampsia in a Private Hospital Setting

Publications regarding the effectiveness of low dose aspirin prophylaxis have repeatedly shown a reduced risk of preeclampsia. The purpose of this study was to investigate whether the effectiveness of the use of low dose aspirin (LDA) in preventing preeclampsia could be replicated in a single hospital setting.

Study Design:

This was a retrospective cohort study of patients who delivered between 1/1/20-3/30/20. Each study participant underwent a rigorous chart review for pre-determined risk factors and outcomes. Patients were identified as low, moderate, or high risk for developing preeclampsia based on current national criteria. Patients who met inclusion criteria were divided into cohorts that either did or did not receive LDA prophylaxis. The incidence of developing a pregnancy-induced hypertensive disorder was compared between cohorts both overall and after stratification into moderate and high risk categories using odds ratios. Maternal, neonatal, and fetal adverse outcomes were also compared between the two cohorts.

Results:

Out of 498 patient charts reviewed, 196 patients were included in the study. Maternal demographics of the two study groups were similar. There was no significant difference in the development of preeclampsia or gestational hypertension amongst the patients who did and did not receive LDA therapy either overall (OR 1.80; CI 0.68 - 4.73) or when stratified into high (OR 1.35; CI 0.29 - 6.38) and moderate risk (OR 3.7; CI 0.22 - 61.3) groups. The highest rate of preeclampsia did occur in the high risk group. Obstetric complications were significant for an increased risk of postpartum hemorrhage (PPH) (OR 4.4; CI 1.2 – 15.9) and anemia (OR 20.7; CI 4.5 – 95.8) requiring transfusion in the LDA group. No neonatal or fetal complications were significantly affected; however, differences approached significance in SGA neonates in the LDA cohort (P = 0.08).

Conclusion:

Prophylactic LDA did not reduce the risk of pregnancy-induced hypertension in our patient population. Patients who underwent LDA therapy did, however, have a significant increased risk of PPH and transfusion.