Low‐dose‐aspirin usage among women with an increased preeclampsia risk: A prospective cohort study

Montfort, Pim van; Scheepers, Hubertina C.J.; Dooren, Ivo M.A. van; Meertens, Linda J. E.; Zelis, Maartje; Zwaan, Iris M.; Spaanderman, Marc E. A.; Smits, Luc

doi:10.1111/aogs.13808

Cited by 23 publications

(14 citation statements)

References 31 publications

(39 reference statements)

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“…This inability to identify with someone who needs medication may be more pronounced during pregnancy as pregnancy is often perceived as a natural/healthy state and is less likely to be perceived as a time when medication is required. A recent publication by van Montfort et al suggests that personalisation of the risks may improve adherence to aspirin in pregnancy (van Montfort et al 2020). This corresponds with wider work in non-obstetric settings advocating for personalised adherence interventions (Petrie, Perry, Broadbent, & Weinman, 2012).…”

Section: Discussionmentioning

confidence: 99%

Aspirin non-adherence in pregnant women at risk of preeclampsia (ANA): a qualitative study

Vinogradov

Smith

Robson

et al. 2021

Health Psychology and Behavioral Medicine

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Background: Antenatal adherence to aspirin prophylaxis is key to reducing the occurrence of a major pregnancy complication: preeclampsia (PE). Up to 75% of pregnant women at increased risk of pre-eclampsia do not take aspirin as prescribed. Little research has been done to understand the psychological determinants of aspirin adherence in pregnancy. This qualitative study aimed to explore barriers and facilitators to aspirin adherence in women at increased risk of PE using version 2 of Theoretical Domains Framework (TDF). Methods: Fourteen women from the North-East of England who declared various levels of non-adherence to aspirin (0-5 of 7 prescribed tablets/week) were interviewed 4-18 months after delivery, using the TDF as a guide. Semi-structured interviews were digitally recorded and transcribed verbatim. A thematic framework analysis was used. Results: Women exhibited both intentional and unintentional nonadherence and faced multiple barriers at a personal and environmental level. They struggled to initiate, implement and persist in taking medication as prescribed. Women expressed inadequate knowledge about PE and aspirin; they struggled to identify as 'medication takers' and relate to the risk factors for PE as identified by the midwife. Significant barriers within the health-care environment were identified; women had difficulties obtaining medication and perceived conflict amongst health care professionals regarding medication safety. Conclusion: A combination of inadequate knowledge, lack of identification with the risk factors and beliefs about consequences of taking medication were interlinked with other domains, such as environmental context and resonate with the Necessity-Concerns Framework.

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Section: Discussionmentioning

confidence: 99%

Aspirin non-adherence in pregnant women at risk of preeclampsia (ANA): a qualitative study

Vinogradov

Smith

Robson

et al. 2021

Health Psychology and Behavioral Medicine

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“…Preeclampsia is a multisystem, pregnancy-related disorder characterized by women with an increased PE risk. Nevertheless, the use of LDA alone does not results in optimum decrease in the risk of PE in many settings [28].…”

Section: Discussionmentioning

confidence: 99%

Sildenafil plus Low Dose Aspirin for Prevention of Preeclampsia: A Randomized Controlled Trial

Ghaleb¹,

Labib²,

Wahba³

2021

OJOG

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Objective: To compare between the efficacy of the use of oral sildenafil plus low dose aspirin versus the use of oral low dose aspirin alone in pregnancy as preventive measure in women at risk for preeclampsia (PE). Design: A randomized clinical trial. Setting: Outpatient Obstetric clinic of Ain Shams University Maternity Hospital. Population or sample: Women at gestational age of ≤16 weeks who at risk for PE between June 2018 and June 2019. Methods: Participants were randomly allocated into two groups: Group I Included 200 women who received a 25 mg tablet of oral sildenafil citrate tid until delivery plus 100 mg tablet of aspirin orally once daily until gestational age of 36 weeks, Group II Included 200 women who received a 100 mg tablet of aspirin orally once daily until gestational age of 36 weeks. Main Outcome Measures: Incidence of preeclampsia diagnosed per ACOG criteria. Results: The incidence of PE in both groups showed no statistically significant difference. The incidence of PE in the first group is 11.0%, and it is 12.0% in the second group (p-value 0.754). Conclusion: The addition of sildenafil citrate to low dose aspirin had no impact on the prevention of preeclampsia for women at risk of PE, in addition, sildenafil did not improve maternal and fetal outcomes.

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“…The reported levels of non-adherence are likely to be underestimated due to the use of self-reported methods of assessment (20,30). Further adherence to a drug by motivated participants in a clinical trial is likely to be higher than in the general obstetric population; van Montfort et al recently reported adherence to aspirin in a non-research setting was only 25% with some highrisk women not ever recalling any discussions regarding aspirin treatment (31). In the ASPRE trial, there was a relationship between aspirin adherence and PE; the OR for preterm PE when adherence was 90% or more (based on a pill count) was 0.24 (95% CI 0.09-0.65) compared to 0.37 (95% CI 0.17-0.82) when adherence was less than 90% of pills (32).…”

Section: Main Findingsmentioning

confidence: 99%

Aspirin non-response in pregnant women at increased risk of pre-eclampsia

Vinogradov

Boag

Murphy

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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Low‐dose‐aspirin usage among women with an increased preeclampsia risk: A prospective cohort study

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 23 publications

References 31 publications

Aspirin non-adherence in pregnant women at risk of preeclampsia (ANA): a qualitative study

Aspirin non-adherence in pregnant women at risk of preeclampsia (ANA): a qualitative study

Sildenafil plus Low Dose Aspirin for Prevention of Preeclampsia: A Randomized Controlled Trial

Aspirin non-response in pregnant women at increased risk of pre-eclampsia

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