Fletcher, Horace M.; Mullings, Anthony M.
Author Affiliation, Ana.
Department of Obstetrics, Gynaecology and Child Health
A randomised trial of low dose aspirin for primiparae in pregnancy.
British Journal of Obstetrics and Gynaecology
Date of Publication
Investigates whether low dose aspirin medication given to primiparous women provides benefits in preventing pre-eclampsia or intrauterine growth retardation. Randomised double-blind controlled trial of low dose aspirin and placebo in pregnancy. Residents of the parishes of Kingston and St Andrew, Jamaica; 6275 primiparae enrolled between 12 and 32 weeks of gestation. Hypertensive disorders of pregnancy (including pre-ecalampsia), preterm delivery, and low birthweight. In addition, to assess whether enrolment early, rather than late had more beneficial effect. Possible adverse effects on the woman and her infant were monitered. Of enrolled primiparae, 97% were followed throughout pregnancy. There were no differences between those on aspirin and those on placebo in the development of hypertensive disorders (e.g. for a rise in diastolic pressure of 25 mmllg the odds ratio [OR] was 1.02 [95%CI 0.86-1.20]: for proteinuiric pre-eclampsia OR 1.15 [95%CI 0.92 1.44] eclampsia OR 0.82 [95%CI 0.44 1.53]; except for oedema which was significantly less likely to deliver preterm (OR 0.93 [95%CI 0.79-1.09] or have a larger fetus (mean birthweight difference 18 g[95% CI -9 to 45]). They were, however, significantly more likely to suffer from bleeding disorders antenatally, intrapartum and postpartum; for postpartum haemorrage OR 1.40 (95% CI 1.13-1.73). This trial shows that low dose aspirin has no consistent beneficial effect in primiparae.....