Low-dose Aspirin for the Prevention of Preterm Delivery in Nulliparous Women With a Singleton Pregnancy (ASPIRIN): A Randomized, Double-blind, Placebo-controlled Trial

Hoffman, Matthew; Goudar, Shivaprasad S.; Kodkany, Bhala; Metgud, Mrityunjay C; Somannavar, Manjunath S; Okitawutshu, Jean; Lokangaka, Adrien; Tshefu, Antoinette; Bose, Carl; Mwapule, Abigail; Mwenechanya, Musaku; Chomba, E; Carlo, Wally; Chicuy, Javier; Figueroa, Lester; Garcés, Arlinis Cabrera; Krebs, Nancy F.; Jessani, Saleem; Zehra, Farnaz; Saleem, Sarah; Goldenberg, R.L.; Kurhe, Kunal; Das, Priyanka; Patel, Ashok Kumar; Hibberd, Patricia L.; Achieng, Emmah; Nyongesa, Paul; Esamai, Fabian; Liechty, Edward A.; Goco, Norman; Hemingway-Foday, Jennifer; Moore, Judith; Nolen, Tracy L.; McClure, EM; Koso‐Thomas, Marion; Miodovnik, Menachem; Silver, Robert; Derman, Richard

doi:10.1097/01.aoa.0000719608.24257.dc

Cited by 2 publications

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“…In a study by Hoffman et al on pregnant women from low- to middle-income countries, low-dose aspiring showed reduced PTD prior to 37 weeks, in addition to decreased perinatal mortality. 25 In contrast, in a study published in 2022 encompassing 608 pregnant women with a history of spontaneous preterm birth, low-dose aspiring did not demonstrate a significant reduction in preterm birth. 26…”

Section: Discussionmentioning

confidence: 90%

Evaluation of the Effect of Low-dose Aspirin on the Prevention of Preterm Delivery in Women with a History of Spontaneous Preterm Delivery

Mirzamoradi,

Dehghani,

Azadi

et al. 2023

Rev Bras Ginecol Obstet

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Objective Currently, uteroplacental vascular disorders are considered one of the main mechanisms of spontaneous preterm delivery (PTD). Low-dose aspirin is used to prevent pre-eclampsia, which has a similar mechanism; hence, the present study aimed to investigate the effect of low-dose aspirin on the prevention of PTD in women with a history of spontaneous PTD. Methods The present pilot randomized clinical trial was conducted on 54 pregnant women in the aspirin group (taking 80 mg daily until the 36th week and classic treatment) and 53 patients in the control group (only receiving classic treatment). Results Forty-three patients (40%) presented before 37 weeks due to symptoms of PTL. Preterm delivery (< 37 weeks) occurred in 28 patients (26%), and there was no significant difference between the aspirin and control groups (10 patients [19%] and 18 patients [34%], respectively; p = 0.069). The time of preterm delivery was early (< 34 weeks) in 6 patients (21%), and its cause was spontaneous labor in 23 patients (82%) which was not significantly different between the two groups (p > 0.05). Out of 40 patients with spontaneous labor, 25 patients (63%) had a PTD, which was significantly lower in the aspirin group than in the control group (9 patients [45%] versus 16 patients [80%], respectively; p = 0.022). Conclusion The findings of the present study demonstrated that despite the reduction in the incidence of PTD using low-dose aspirin, the reduction rate was not statistically significant. On the other hand, in patients with spontaneous labor prone to PTD, aspirin was effective in reducing the incidence of PTD.

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Section: Discussionmentioning

confidence: 90%

Evaluation of the Effect of Low-dose Aspirin on the Prevention of Preterm Delivery in Women with a History of Spontaneous Preterm Delivery

Mirzamoradi,

Dehghani,

Azadi

et al. 2023

Rev Bras Ginecol Obstet

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“…There may be multiple contributors to the racial disparities in cesarean delivery and pregnancy-associated hypertension that are unrelated to racial differences in labor induction. For example, clinician biases and resource constraints may be associated with suboptimal use of low-dose aspirin for the prevention 26 of pregnancy-associated hypertension.…”

Section: Discussionmentioning

confidence: 99%

Obstetric Racial Disparities in the Era of the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) Trial and the Coronavirus Disease 2019 (COVID-19) Pandemic

Wheeler,

Truong,

Unnithan

et al. 2024

Obstetrics &Amp; Gynecology

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OBJECTIVE: To evaluate the influence of the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) trial and the coronavirus disease 2019 (COVID-19) pandemic on racial and ethnic differences in labor induction, pregnancy-associated hypertension, and cesarean delivery among non-Hispanic Black and non-Hispanic White low-risk, first-time pregnancies. METHODS: We conducted an interrupted time series analysis of U.S. birth certificate data from maternal non-Hispanic Black and non-Hispanic White race and ethnicity, first pregnancy, 39 or more weeks of gestation, with no documented contraindication to vaginal delivery or expectant management beyond 39 weeks. We compared the rate of labor induction (primary outcome), pregnancy-associated hypertension, and cesarean delivery during three time periods: pre-ARRIVE (January 1, 2015–July 31, 2018), post-ARRIVE (November 1, 2018–February 29, 2020), and post-COVID-19 (March 1, 2020–December 31, 2021). RESULTS: In the post-ARRIVE period, the rate of labor induction increased in both non-Hispanic White and non-Hispanic Black patients, with no statistically significant difference in the magnitude of increase between the two groups (rate ratio for race [RRrace] 0.98, 95% CI, 0.95–1.02, P=.289). Post-COVID-19, the rate of labor induction increased in non-Hispanic White but not non-Hispanic Black patients. The magnitude of the rate change between non-Hispanic White and non-Hispanic Black patients was significant (RRrace 0.95, 95% CI, 0.92–0.99, P=.009). Non-Hispanic Black pregnant people were more likely to have pregnancy-associated hypertension and more often delivered by cesarean at all time periods. CONCLUSION: Changes in obstetric practice after both the ARRIVE trial and the COVID-19 pandemic were not associated with changes in Black–White racial differences in labor induction, cesarean delivery, and pregnancy-associated hypertension.

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Low-dose Aspirin for the Prevention of Preterm Delivery in Nulliparous Women With a Singleton Pregnancy (ASPIRIN): A Randomized, Double-blind, Placebo-controlled Trial

Cited by 2 publications

References 0 publications

Evaluation of the Effect of Low-dose Aspirin on the Prevention of Preterm Delivery in Women with a History of Spontaneous Preterm Delivery

Evaluation of the Effect of Low-dose Aspirin on the Prevention of Preterm Delivery in Women with a History of Spontaneous Preterm Delivery

Obstetric Racial Disparities in the Era of the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) Trial and the Coronavirus Disease 2019 (COVID-19) Pandemic

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