American Journal of Perinatology, Table of Contents

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

¹UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland

,

Cecilia Mulcahy

¹UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland

,

Peter McParland

¹UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland

,

Paul Downey

²Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland

,

Marie Culliton

²Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland

,

Orla C. Maguire

²Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland

,

Eoghan E. Mooney

²Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland

,

Philip Clarke

²Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland

,

David Fitzgerald

³Department of Pharmacy, National Maternity Hospital, Dublin, Ireland

,

Elizabeth Tully

⁴Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Fergal D. Malone

⁴Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Fionnuala M. McAuliffe

¹UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland

› Author Affiliations

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

Keywords

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

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