title: Low-dose aspirin for pre-eclampsia prevention in twins with elevated human chorionic gonadotropin.
abstract: The objective of the study is to evaluate low-dose aspirin (LDA) for pre-eclampsia prevention in twin gestations with elevated maternal serum human chorionic gonadotropin (hCG).
  
  
  
  Secondary analysis of the Maternal-Fetal Medicine Units High-Risk Aspirin trial for pre-eclampsia prevention. A threshold hCG level for predicting pre-eclampsia was identified in placebo-randomized patients. Pre-eclampsia incidence and time of onset were compared between treatment groups, overall and by hCG threshold category.
  
  
  
  Pre-eclampsia incidence was lower with LDA than with placebo (6% vs 16%, OR 0.32, 95% CI 0.12 to 0.82). An hCG threshold of 29.96 IU ml(-1) best predicted pre-eclampsia. In patients with hCG <29.96 IU ml(-1), the differences in pre-eclampsia incidence or time of onset were not significant. In patients with hCG >29.96 IU ml(-1), LDA was associated with lower pre-eclampsia incidence than placebo (6% vs 23%, OR 0.21, 95% CI 0.06 to 0.79) and delayed onset.
  
  
  
  Twin gestations with elevated hCG levels may benefit from LDA for pre-eclampsia prevention.
authors.affiliation: University of Colorado Denver, Department of Obstetrics and Gynecology, Aurora, CO, USA.
authors.forename: A G
authors.initials: AG
authors.lastname: Euser
authors.affiliation: University of Colorado Denver, Department of Obstetrics and Gynecology, Aurora, CO, USA.|Denver Health Medical Center, Department of Obstetrics and Gynecology, Denver, CO, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Metz
authors.affiliation: University of Colorado School of Public Health, Aurora, CO, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Allshouse
authors.affiliation: University of Colorado Denver, Department of Obstetrics and Gynecology, Aurora, CO, USA.|Denver Health Medical Center, Department of Obstetrics and Gynecology, Denver, CO, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Heyborne
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage*; D006063:Chorionic Gonadotropin / Q000097:blood*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000517:prevention & control*; D059285:Pregnancy, Twin; D011295:Prenatal Care; D012372:ROC Curve; D014481:United States; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D001241:Aspirin