Low-dose aspirin to prevent preeclampsia and growth restriction in nulliparous women identified by uterine artery Doppler as at high risk of preeclampsia: A double blinded randomized placebo-controlled trial

Diguisto, Caroline; Gouge, Amélie Le; Marchand, M; Megier, P.; Ville, Y.; Haddad, Georges; Winer, Norbert; Arthuis, Chloé; Doret, Muriel; Debarge, V.; Flandrin, A.; Delmas, Hélène Laurichesse; Gallot, Denis; Marès, P.; Vayssière, Christophe; Sentilhes, Loïc; Cheve, Marie-Thérèse; Paumier, Anne; Durin, Luc; Schaub, Bruno; Equy, V.; Giraudeau, Bruno; Perrotin, Franck

doi:10.1371/journal.pone.0275129

Cited by 4 publications

(4 citation statements)

References 31 publications

(37 reference statements)

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“…DROP is a screening protocol for trisomy 21 and early detection of preeclampsia and evaluation of its preventive treatment with low‐dose aspirin. According to the French National Conference on Obstetrical and Fetal Sonography and French Health Care recommendations, first trimester sonography must be conducted between 11+0 and 13+6 weeks of amenorrhea 25 , 26 Thus, the DROP study was offered to all women presenting themselves for the first trimester sonography (between 11+0 and 13+6 weeks of amenorrhea) in the prenatal diagnosis department of the Paule de Viguier Hospital in Toulouse's Public Teaching Hospital (CHU de Toulouse, France). The PERISCOPE study was conducted in the prenatal diagnosis department by three trained, qualified and calibrated investigators (CT, IT and EB).…”

Section: Methodsmentioning

confidence: 99%

“…According to the French National Conference on Obstetrical and Fetal Sonography and French Health Care recommendations, first trimester sonography must be conducted between 11+0 and 13+6 weeks of amenorrhea 25,26 Thus, the DROP study was offered to all women presenting themselves for the first trimester sonography (between 11+0 and 13+6 weeks of amenorrhea) in the prenatal diagnosis department of the Paule de Viguier Hospital in Toulouse's Public Teaching Hospital (CHU de Toulouse, France).…”

Section: Key Messagementioning

confidence: 99%

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Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study

Thomas

Timofeeva

Bouchoucha

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Periodontal diseases (gingivitis and periodontitis) are chronic non‐communicable inflammatory diseases. The risk of developing gingivitis and periodontitis increases during pregnancy. Also, periodontitis increases the risk of developing adverse pregnancy outcomes such as preterm birth and preeclampsia. Early diagnosis of adverse pregnancy outcomes is essential and periodontitis could be an early sign to take into consideration. Material and methods We conducted a longitudinal observational study (PERISCOPE study: CNIL, no. 1 967 084 v 0; CER, no. 01–0416) on 121 pregnant women in the first trimester to determine their oral and periodontal health status. We explored the relations between oral and periodontal health status and sociodemographic and behavior characteristics, as well as their course and outcome of pregnancy. Results A total of 47.1% of the women had periodontitis, of which only 66.7% presented clinical manifestations associated with the disease such as gingival bleeding. These women had a poorer oral and periodontal health, and a higher body mass index, and more of them developed gestational diabetes during the course of pregnancy. The remaining 33.3% showed only discreet and isolated inflammatory signs and, unless thoroughly examined, would have gone undiagnosed for periodontitis. Interestingly these women were more often primiparous, still active professionally and had had a recent oral examination. Conclusions The PERISCOPE study is one of the few studies that reports the oral and periodontal health status of pregnant women in the first trimester. Furthermore, the results highlight the need for early oral and periodontal assessment and treatment, even in the absence of exterior clinical signs, in order to prevent periodontal disease aggravation and also, by reducing low grade systemic inflammation, possibly adverse pregnancy outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Key Messagementioning

confidence: 99%

Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study

Thomas

Timofeeva

Bouchoucha

et al. 2023

Acta Obstet Gynecol Scand

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“…Among them, 54 articles initially met the inclusion criteria. After a full‐text review of these 54 articles, a total of 23 RCTs 16 , 19 , 21 , 22 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 met the inclusion criteria (Figure 1 ). A total of 10 547 pregnant women with high‐risk factors for preeclampsia were included.…”

Section: Resultsmentioning

confidence: 99%

The optimal dosage of aspirin for preventing preeclampsia in high‐risk pregnant women: A network meta‐analysis of 23 randomized controlled trials

Hu,

Chen,

Wang

et al. 2024

J of Clinical Hypertension

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This study aimed to assess the effectiveness and optimal dosage of aspirin in preventing preeclampsia in high‐risk pregnant women. Traditional and network meta‐analyses were conducted on data from 23 randomized controlled trials involving 10 547 pregnant women. The findings demonstrated that aspirin significantly reduced the incidence of preeclampsia (OR = 0.66, 95%CI [0.58, 0.75]), with the best preventive effect observed at a dosage of 80–100 mg/day (OR = 0.51, 95%CI [0.36, 0.72]). No significant differences were found in the occurrence of postpartum hemorrhage (OR = 1.03, 95%CI [0.79, 1.33]), small for gestational age (OR = 0.83, 95%CI [0.50, 1.35]), placental abruption (OR = 0.96, 95%CI [0.53, 1.73]), and intrauterine growth restriction (OR = 0.63, 95%CI [0.45, 1.86]) between women taking aspirin and those taking placebos. Different doses of aspirin showed a reduction in preeclampsia incidence, but there was no significant difference in efficacy between the dosage groups. Side effects did not significantly differ between placebo and different aspirin dosage groups. SUCRA analysis suggested that 80–100 mg/day may be the optimal dosage, prioritizing both effectiveness and minimizing side effects. Sensitivity analysis confirmed the robustness of the findings. However, improvements are needed in addressing issues like loss to follow‐up, reporting bias, and publication bias. In conclusion, a dosage of 80–100 mg/day is recommended for preventing preeclampsia in high‐risk pregnant women, although individual circumstances should be considered for optimizing the balance between effectiveness and safety.

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“…Low-dose aspirin (acetylsalicylic acid) has been widely used to improve pregnancy outcomes, specifically in preventing PIH and FGR [ 6 ]. The administration of daily oral doses ranging from 50 to 150 mg effectively inhibits platelet thromboxane A2 biosynthesis, thus mitigating potential complications.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Impact of Uterine Artery Doppler and Low-Dose Aspirin on Fetomaternal Outcome: A Prospective Study in Low-Risk Pregnant Women in Western Part of India

Patel,

Machave

et al. 2023

Cureus

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Introduction Fetal growth restriction (FGR) and pregnancy-induced hypertension (PIH) are significant and clinically relevant complications observed in many pregnancies. Early prediction of these complications may be possible through the assessment of the umbilical artery pulsatility index (UAPI). However, its utility in routine practice for otherwise normal pregnancy needs further exploration in India. Objectives This study aimed to evaluate the potential benefits of incorporating UAPI for the timely use of low-dose aspirin in preventing FGR and PIH in a tertiary care hospital in the western part of India. Methodology A prospective study was conducted involving 64 low-risk (i.e., not having any feature of high-risk pregnancy) pregnant women selected from routine antenatal care outpatient departments over a period of two years. All women underwent uterine artery Doppler examination during the 11-13+6 weeks of pregnancy and those who had high UAPI received low-dose (150 mg) aspirin till the 35th week. The incidence of FGR and PIH was analyzed and compared between high UAPI and normal UAPI pregnancy. Results A total of 64 pregnant women with a mean age of 27.11±4 years participated in the study. Among the women, eight (12.5%) were found to have high UAPI and were put on aspirin. Among those eight women, two developed PIH. In the normal UAPI group, nine (16.07%) developed PIH (p-value = 0.62). FGR was found in one case among the eight who received aspirin and in eight cases among the 56 who had normal UAPI (p-value > 0.99). Conclusion The study concluded that despite having normal UAPI, women categorized as low-risk may develop PIH and FGR. Hence, the routine use of UAPI should be investigated in further cohort studies using a large sample to draw a generalizable conclusion for the Indian population.

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Low-dose aspirin to prevent preeclampsia and growth restriction in nulliparous women identified by uterine artery Doppler as at high risk of preeclampsia: A double blinded randomized placebo-controlled trial

Cited by 4 publications

References 31 publications

Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study

Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study

The optimal dosage of aspirin for preventing preeclampsia in high‐risk pregnant women: A network meta‐analysis of 23 randomized controlled trials

Assessing the Impact of Uterine Artery Doppler and Low-Dose Aspirin on Fetomaternal Outcome: A Prospective Study in Low-Risk Pregnant Women in Western Part of India

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