Mid-trimester uterine artery Doppler for aspirin discontinuation in pregnancies at high risk for preterm pre-eclampsia : Post-hoc analysis of StopPRE trial
Bonacina, Erika (Hospital Universitari Vall d'Hebron)
Garcia-Manau, Pablo (Hospital Universitari Vall d'Hebron)
López, Mónica (Hospital Universitari Joan XXIII de Tarragona)
Caamiña Álvarez, Sara (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Vives, Àngels (Department of Obstetrics. Consorci Sanitari de Terrassa)
Lopez-Quesada, Eva (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Ricart, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Maroto, Anna (Hospital Universitari de Girona Doctor Josep Trueta)
de Mingo, Laura (Hospital Universitario Severo Ochoa)
Pintado, Elena (Hospital Universitario de Getafe (Madrid))
Castillo-Ribelles, Laura (Hospital Universitari Vall d'Hebron)
Martín, Lourdes (Hospital Universitari Joan XXIII de Tarragona)
Rodriguez-Zurita, Alicia (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Garcia, Esperanza (Consorci Sanitari de Terrassa)
Pallarols, Mar (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Vidal-Sagnier, Laia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Teixidor, Mireia (Hospital Universitari de Girona Doctor Josep Trueta)
Orizales-Lago, Carmen (Hospital Universitario Severo Ochoa)
Pérez-Gomez, Adela (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Ocaña, Vanesa (Hospital Universitario de Getafe (Madrid))
Puerto, Lidia (Hospital Universitari Joan XXIII de Tarragona)
Millán, Pilar (Consorci Sanitari de Terrassa)
Alsius, Mercè (Hospital Universitari de Girona Doctor Josep Trueta)
Díaz Rodríguez, Sonia (Hospital Universitario de Getafe (Madrid))
Maiz, Nerea (Hospital Universitari Vall d'Hebron)
Carreras Moratonas, Elena (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Suy, A. (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Mendoza, Manel (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)

Date:	2023
Abstract:	Objective: To assess whether aspirin treatment can be discontinued in pregnancies with normal uterine artery pulsatility index (≤90th percentile) at 24-28 weeks. Design: Post-hoc analysis of a clinical trial. Setting: Nine maternity hospitals in Spain. Population or Sample: Pregnant individuals at high risk of pre-eclampsia at 11-13 weeks and normal uterine artery Doppler at 24-28 weeks. Methods: All participants received treatment with daily aspirin at a dose of 150 mg. Participants were randomly assigned, in a 1:1 ratio, either to continue aspirin treatment until 36 weeks (control group) or to discontinue aspirin treatment (intervention group), between September 2019 and September 2021. In this secondary analysis, women with a UtAPI >90th percentile at 24-28 weeks were excluded. The non-inferiority margin was set at a difference of 1. 9% for the incidence of preterm pre-eclampsia. Main outcome measures: Incidence of preterm pre-eclampsia. Results: Of the 1611 eligible women, 139 were excluded for UtAPI >90th percentile or if UtAPI was not available. Finally, 804 were included in this post-hoc analysis. Preterm pre-eclampsia occurred in three of 409 (0. 7%) women in the aspirin discontinuation group and five of 395 (1. 3%) women in the continuation group (−0. 53; 95% CI −1. 91 to 0. 85), indicating non-inferiority of aspirin discontinuation. Conclusions: Discontinuing aspirin treatment at 24-28 weeks in women with a UtAPI ≤90th percentile was non-inferior to continuing aspirin treatment until 36 weeks for preventing preterm pre-eclampsia.
Grants:	Instituto de Salud Carlos III PI17/01944
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Aspirin ; Doppler ; Pre-eclampsia ; Salicylic acid ; Screening ; Uterine artery
Published in:	BJOG, Vol.131 (2023) , ISSN 1471-0528

DOI: 10.1111/1471-0528.17631

9 p, 3.8 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles