title: Early initiation of low-dose aspirin for reduction in preeclampsia risk in high-risk women: a secondary analysis of the MFMU High-Risk Aspirin Study.
abstract: OBJECTIVE
  Early initiation of low-dose aspirin (LDA) may reduce preeclampsia risk. We sought to determine whether LDA was beneficial when initiated <17w0d, within a trial of high-risk women enrolled <26w0d.
  
  
  METHODS
  Secondary analysis of the Maternal-Fetal Medicine Units High-Risk Aspirin study, including women enrolled <17w0d, randomized to LDA (60 mg day(-1)) or placebo with chronic hypertension (CHTN, n=186), diabetes (n=191) or prior preeclampsia (n=146). The primary outcome was preeclampsia at any time in pregnancy, secondary outcomes were early preeclampsia (<34w0d), late preeclampsia (⩾34w), small for gestational age (SGA; neonatal birthweight <10th %) and composite (early preeclampsia or SGA). Outcomes were compared by exact Χ(2)-tests.
  
  
  RESULTS
  Baseline characteristics were similar between treatment groups. Aspirin was associated with a lower rate of late-onset preeclampsia ⩾34w (17.36% vs 24.42%, P=0.047), with a 41% reduction in women with CHTN (18.28% vs 31.18%, P=0.041). There were no other significant differences in the outcome.
  
  
  CONCLUSIONS
  Aspirin initiated <17w0d reduced the risk for late-onset preeclampsia by 29% supporting the practice of early initiation of aspirin in high-risk women.
authors.affiliation: University of Colorado Department of Obstetrics and Gynecology, Aurora, CO, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Moore
authors.affiliation: Colorado School of Public Health, Aurora, CO, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Allshouse
authors.affiliation: University of Colorado Department of Obstetrics and Gynecology, Aurora, CO, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Post
authors.affiliation: University of Colorado Department of Obstetrics and Gynecology, Aurora, CO, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Galan
authors.affiliation: University of Colorado Department of Obstetrics and Gynecology, Aurora, CO, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Heyborne
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage*; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
chemical_list: D001241:Aspirin