Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality

Henderson, Jillian T.; Vesco, Kimberly K.; Senger, Caitlyn A; Thomas, Rachel; Redmond, Nadia

doi:10.1001/jama.2021.8551

Cited by 116 publications

(106 citation statements)

References 104 publications

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“…Increased platelet activity has previously been linked to both preeclampsia 4–6 and spontaneous preterm birth 12–14 . Aspirin therapy, in addition reducing the risk of preeclampsia 16 has been associated with reduced risk of overall preterm birth, 15,28 and spontaneous preterm birth in both low‐ and high‐risk pregnant singletons 17,18,28,29 . Our findings build on these prior studies by identifying a genetic contributor to increased platelet activation and an associated increased risk of preterm birth.…”

Section: Results In the Context Of What Is Knownsupporting

confidence: 64%

“…Similarly, platelet activation has been associated with spontaneous preterm birth, 12 and uteroplacental ischemia and vascular disorders contribute to the pathogenesis of preterm birth 13,14 . The contribution of platelet activation in preterm birth and preeclampsia is further supported by studies demonstrating the efficacy of antiplatelet agents, most commonly aspirin, in prevention of preeclampsia and spontaneous preterm birth 15–18 …”

Section: Introductionmentioning

confidence: 98%

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Platelet protease activated receptor 4 (PAR 4) receptor genotype is associated with an increased risk of preterm birth

Boelig

Cahanap

et al. 2022

Journal of Thrombosis and Haemostasis

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Background: Platelet protease activated receptor-4 (PAR4) Thr120 is a common genetic variant associated with increased platelet activity. Increased platelet activity is implicated in the pathogenesis of preeclampsia and preterm birth.Objective: Compare the rate of preeclampsia and preterm birth in pregnant individuals homozygous for PAR4 Thr120 variant vs not.Study Design: This is a prospective cohort study of patients who delivered November 2020-July 2021. Maternal blood collected on admission for PAR4 genotyping. The primary outcome was the rate of preeclampsia/gestational hypertension in those with Thr/Thr genotype compared with Ala/Thr or Ala/Ala. Secondary outcomes included rates of preterm birth and placental pathology.Results: Three hundred and twenty singletons were included and 52 (16.3%) were PAR4 Thr/Thr. Those PAR4 Thr/Thr were more likely to be Black (67.3% vs 29.5%, p < .001), younger (28 ± 6 vs 31 ± 6, p = .004), and have higher body mass index (35.2 ± 6.8 vs 33.1 ± 7.4, p = .047). There was no difference in preeclampsia/gestational hypertension (19.2% vs 22.8%, p = .705). Those Thr/Thr had a significantly higher rate of preterm birth (15.4% vs 3.7%, adjusted odds ratio [aOR] 4. 04 [1.47-11.10],

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Section: Results In the Context Of What Is Knownsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 98%

Platelet protease activated receptor 4 (PAR 4) receptor genotype is associated with an increased risk of preterm birth

Boelig

Cahanap

et al. 2022

Journal of Thrombosis and Haemostasis

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“…The severity of PE varies significantly, and the state of an illness develops unpredictably in patients, further leading to maternal eclampsia, stroke, placental abruption, organ damage, and even death. In addition, PE can also lead to severe fetal and neonatal damage, including intrauterine growth restriction (IUGR), low birth weight (LBW) among infants, premature birth, stillbirth, and even neonatal death (3). PE is a multifactorial disorder with a complex pathogenesis involving maternal and placental vascular dysfunction.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Potential of Gut Microbiota-Derived Short-Chain Fatty Acids in Preeclampsia

Wang²,

Chen³

et al. 2022

Front. Pediatr.

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Preeclampsia (PE) is a complex pregnancy-related hypertensive disorder leading to multiorgan dysfunction. It has high maternal, fetal, and neonatal morbidity and mortality rates. The study of gut microbiota and its metabolites in PE deserves further exploration. Thirty-eight pregnant women with PE and 29 healthy pregnant women in the third trimester of their pregnancy were recruited in this study. We used a targeted metabolomics approach to evaluate the short-chain fatty acids (SCFAs) in serum samples. The correlation between SCFAs and clinical characteristics was also explored. The results of mass spectrometry (MS) showed significant differences at the metabolomics level of SCFAs between the PE and healthy control. The metabolic levels of acetate, propionate, isobutyrate, and valerate were significantly increased in the PE group than in the healthy control group. In contrast, caproic acid and butyrate levels were significantly reduced. The correlation analysis showed that urea, systolic, and diastolic blood pressure levels were positively correlated with four types of SCFAs (acetic acid, propionic acid, isobutyric acid, and valeric acid) which increased in the PE group. Furthermore, the neutrophil percentage and the fetal birth weight were negatively correlated with isobutyric acid and valeric acid. In addition, the receiver operating characteristic (ROC) analysis using a generalized linear model showed that multiple SCFAs would be potential diagnostic markers for PE, with high specificity, sensitivity, and area under the curve (AUC). Among them, isobutyric acid (sensitivity: 97.4%, specificity: 100%, AUC = 1.00), propionic acid (sensitivity: 86.8%, specificity: 93.3%, AUC = 0.954) and acetic acid (sensitivity: 86.8%, specificity: 83.3%, AUC = 0.891) depicted significantly higher diagnostic value and potential clinical applications. In summary, the results of this study indicate that SCFAs have the potential to become effective biomarkers for early screening of PE.

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“…Зниження СР при ранній ПЕ (до 34 тижнів) є більшим, але становить лише невелику частку випадків (до 30,0%) [4]. Хоча цей Кокранівський огляд демонструє обнадійливі тенденції, залишається незрозумілим, чи запобігають розвитку ПЕ інші препарати, що їх призначають в Україні [20,24,48]. Тому існує потреба у визначенні потенційно нових фармакологічних засобів для профілактики розвитку ВПП внаслідок ранньої або пізньої форм ПЕ.…”

Section: вступunclassified

Optimization of the prevention of perinatal pathology in women with gestational endotheliopathy

Konkov

Kosianenko

Ostreniuk

et al. 2022

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Objectives: to evaluate the clinical effectiveness of the Metida for the prevention of perinatal pathology in pregnant women with gestational endotheliopathy and with the risk of preeclampsia.Materials and methods. 68 pregnant women with verified gestational endotheliopathy and with risk of preeclampsia > 1:150 participated in a prospective clinical comparative study. The patients were divided into subgroups: the first subgroup included 30 women who from 11–13 weeks of pregnancy received acetylsalicylic acid 100 mg/day and vitamin D 2000 IU/day; the II subgroup included 38 pregnant women who from 11–13 weeks of gestation received acetylsalicylic acid 100 mg/day, vitamin D 2000 IU/day and Metida (300 mg of elemental magnesium, 30 mg of vitamin B6). 28 practically healthy pregnant women of the control group received vitamin D 1000 IU/day. The clinical effectiveness of therapy was evaluated by comparing the number of cases of perinatal pathology; cases of intrauterine suffering of the fetus; the dynamics of indicators of laboratory-instrumental research methods (markers of the risk of perinatal pathology) and the pregnancy outcomes.Results. Metida as an additional preventive therapy made it possible to significantly reduce the number of cases of placental dysfunction (р = 0.01) and intrauterine suffering of the fetus (р = 0.02) compared to standard preventive therapy. There was also a 6-fold reduction in the incidence of preeclampsia and premature birth due to magnesium supplementation, compared to pregnant women who received only acetylsalicylic acid and vitamin D. There was a significant decrease in serum indicators of markers of endothelial dysfunction in women with gestational endotheliopathy as a result of taking magnesium: vascular endothelial growth factor (p < 0.00001), endoglin (p < 0.00001) compared to patients who did not receive magnesium, and there was also normalization of the of 25(OH)D level in blood serum compared to the control group (p = 0.33).Conclusions. Additional Mg supplementation during pregnancy may reduce the likelihood of perinatal pathology in high-risk patients and help normalize serum markers of endothelial dysfunction in women with high risk of preeclampsia.

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Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality

Cited by 116 publications

References 104 publications

Platelet protease activated receptor 4 (PAR 4) receptor genotype is associated with an increased risk of preterm birth

Platelet protease activated receptor 4 (PAR 4) receptor genotype is associated with an increased risk of preterm birth

The Diagnostic Potential of Gut Microbiota-Derived Short-Chain Fatty Acids in Preeclampsia

Optimization of the prevention of perinatal pathology in women with gestational endotheliopathy

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