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Am J Perinatol 2019; 36(13): 1387-1393
DOI: 10.1055/s-0038-1677476
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of the Effect of Low-Dose Aspirin on Biochemical and Biophysical Biomarkers for Placental Disease in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT

Fionnuala Mone
1   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
,
Cecilia Mulcahy
1   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
,
Peter McParland
1   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
,
Paul Downey
2   Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
,
Marie Culliton
2   Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
,
Orla C. Maguire
2   Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
,
Eoghan E. Mooney
2   Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
,
Philip Clarke
2   Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
,
David Fitzgerald
3   Department of Pharmacy, National Maternity Hospital, Dublin, Ireland
,
Elizabeth Tully
4   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Fergal D. Malone
4   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Fionnuala M. McAuliffe
1   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
› Author Affiliations Funding This trial was funded by Perinatal Ireland, HRB and the Mother and Baby Clinical Trials Network, HRB.
Further Information

Publication History

21 September 2018

29 November 2018

Publication Date:
15 January 2019 (online)

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Abstract

Objective To assess the effect of aspirin use in low-risk pregnancy on: (1) pregnancy-associated plasma protein-A (PAPP-A) and placental-like growth factor (PLGF); (2) urinary albumin-to-creatinine ratio (ACR) and blood pressure; (3) fetal growth parameters; and (4) placental histopathology.

Study Design This secondary analysis from the T rial of low-dose aspirin with an E arly S creening T est for preeclampsia and growth restriction randomized controlled trial was based on low-risk nulliparous women randomized at 11 weeks to (1) aspirin 75 mg; (2) no aspirin; and (3) aspirin based on the preeclampsia Fetal Medicine Foundation screening test. At baseline, women underwent assessment of blood pressure, PAPP-A, PLGF, and ACR, repeated 9 to 10 weeks postaspirin, in addition to fetal growth assessment. Gross and histopathological placental analyses were performed in line with Amsterdam criteria.

Results A total of 445 subjects were included (aspirin n = 163 [36.6%]; no aspirin n = 282 [63.4%]). Although the fetal-to-placental weight ratio was significantly greater in the aspirin group (7.5 [±1.3] vs. 7.3 [±1.4], p = 0.045), as was change in ultrasound assessed estimated fetal weight from second to third trimesters (1,624.5 g [±235.1] vs. 1,606.2 [±189.4], p = 0.042), this was invalidated by the lack of a difference in birth weight. Aspirin did not significantly impact on change in serum or urine preeclampsia biomarkers, maternal blood pressure, or placental histopathology.

Conclusion Aspirin use in low-risk pregnancy does not appear to impact on preeclampsia biomarkers, fetal growth, or placental pathology.

Keywords

aspirin - pregnancy-associated protein A - placental-like growth factor - albumin-to-creatinine ratio - fetal growth - placental histopathology

Note

This study was conducted at the National Maternity Hospital, Holles Street, Dublin, Ireland.