Aspirin Discontinuation Noninferior for Preventing Preeclampsia

THURSDAY, March 2, 2023 (HealthDay News) -- For pregnant individuals at high risk for preeclampsia with a normal soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1:PlGF) ratio, aspirin discontinuation between 24 and 28 weeks of gestation is noninferior to aspirin continuation to 36 weeks of gestation for preventing preterm preeclampsia, according to a study published in the Feb. 21 issue of the Journal of the American Medical Association.

Manel Mendoza, Ph.D., from the Universitat Autònoma de Barcelona in Spain, and colleagues conducted a multicenter randomized, phase 3, noninferiority trial in nine maternity hospitals across Spain to examine whether aspirin discontinuation at 24 to 28 weeks of gestation was noninferior to aspirin continuation to prevent preterm preeclampsia in pregnant individuals. Participants at high risk for preeclampsia during the first-trimester screening and an sFlt-1:PlGF ratio of 38 or less at 24 to 28 weeks of gestation were randomly assigned to aspirin discontinuation (intervention group) or aspirin continuation until 36 weeks of gestation (control group; 473 and 463, respectively).

The researchers found that the incidence of preterm preeclampsia was 1.48 and 1.73 percent in the intervention and control groups, respectively (absolute difference, −0.25 percent; 95 percent confidence interval, −1.86 to 1.36 percent), indicating noninferiority.

"The main strength of this study was that the novel evidence suggests that it may be unnecessary to continue aspirin until 36 weeks of gestation in all cases," the authors write. "Earlier discontinuation could ultimately reduce the risk of bleeding complications and pregnancy complications at term."

One author disclosed financial ties to Roche Diagnostics.

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