Aspirin has been shown to significantly reduce the incidence of preterm preeclampsia in pregnant individuals at high risk of developing the condition. However, it has also been associated with an increased risk of peripartum bleeding. Therefore, it is important to determine whether discontinuing aspirin at a certain point in pregnancy is a safe and effective approach to preventing preterm preeclampsia.
A clinical trial aimed to determine whether aspirin discontinuation in pregnant individuals with normal soluble fms-like tyrosine kinase–1 to placental growth factor (sFlt-1:PlGF) ratio between 24 and 28 weeks of gestation was non-inferior to aspirin continuation to prevent preterm preeclampsia. The study involved 936 pregnant individuals at high risk of preeclampsia during the first-trimester screening and an sFlt-1:PlGF ratio of 38 or less at 24 to 28 weeks of gestation.
The participants were randomly assigned to either aspirin discontinuation (intervention group) or aspirin continuation until 36 weeks of gestation (control group). The study found that aspirin discontinuation at 24 to 28 weeks of gestation was non-inferior to aspirin continuation for preventing preterm preeclampsia in pregnant individuals at high risk of preeclampsia and a normal sFlt-1:PlGF ratio.
The incidence of preterm preeclampsia was 1.48% in the intervention group and 1.73% in the control group (absolute difference, −0.25%), indicating noninferiority. Therefore, it may be safe and effective to discontinue aspirin in pregnant individuals with a normal sFlt-1:PlGF ratio at 24 to 28 weeks of gestation, without increasing the risk of preterm preeclampsia.
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The findings of this study may have significant implications for pregnant individuals who are at high risk of developing preterm preeclampsia. It may allow for more personalized and tailored approaches to prenatal care, as well as reduce the risk of unnecessary interventions and adverse outcomes.
It is important to note, however, that this study only applies to individuals who are at high risk of preeclampsia and have a normal sFlt-1:PlGF ratio. Therefore, it is important to consult with a healthcare provider before making any decisions regarding the use of aspirin during pregnancy.
Additionally, the study only assessed the risk of preterm preeclampsia and did not examine the potential risks or benefits of aspirin use in preventing other adverse outcomes during pregnancy. Therefore, further research is needed to fully understand the potential benefits and risks of aspirin use during pregnancy.
The clinical trial found that aspirin discontinuation at 24 to 28 weeks of gestation is non-inferior to aspirin continuation for preventing preterm preeclampsia in pregnant individuals at high risk of preeclampsia and a normal sFlt-1:PlGF ratio. This may have significant implications for prenatal care and allow for more personalized approaches to managing high-risk pregnancies. However, it is important to consult with a healthcare provider before making any decisions regarding the use of aspirin during pregnancy.
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