ROLE OF LOW DOSE ASPIRIN FOR PREVENTION OF PRE-TERM BIRTH IN PREGNANT WOMEN WITH PREVIOUS HISTORY OF PRE-TERM LABOR
DOI:
https://doi.org/10.70520/kjms.v18i3.688Keywords:
Aspirin, Preterm Birth, Randomized Controlled TrialAbstract
Objective: To evaluate the role of low-dose aspirin in preventing preterm births in pregnant women with a history of preterm labor.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, MTI-HMC Peshawar, from 18th Sep 2024 to 18th Mar 2025.
Methodology: A total of 384 pregnant women with a history of preterm labor and gestational age between 6 and 20 weeks were included. Participants were allocated into two groups through a non-random sequential allocation method designed to ensure comparable group sizes. Women in Group A received 75 mg of low-dose aspirin daily until 37 weeks of gestation, while those in Group B received placebo. All analyses were performed using SPSS version 26.0. The chi-square test, with a p-value <0.05, is considered statistically significant.
Results: The mean age was 30.01 ± 6.34 years in Group A and 28.98 ± 6.64 years in Group B, with similar parity. The mean gestational age at delivery was 33.41 ± 4.93 weeks in Group A and 27.40 ± 4.32 weeks in Group B. Preterm birth occurred in 20.3% of Group A compared to 81.3% of Group B (p < 0.001). The mean APGAR score at 1 minute was 8.04 ± 0.81 in Group A and 2.46 ± 1.76 in Group B, while at 5 minutes it was 8.41 ± 0.49 and 3.08 ± 1.96, respectively (p < 0.001).
Conclusion: Low-dose aspirin significantly reduces preterm birth rates and improves neonatal outcomes, including APGAR scores and NICU admissions.
References
1. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-5.
2. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet Global Health. 2019;7(1):e37-e46.
3. Bilsteen JF, Taylor-Robinson D, Børch K, Strandberg-Larsen K, Nybo Andersen AM. Gestational Age and Socioeconomic Achievements in Young Adulthood: A Danish
4. Population-Based Study. JAMA Network Open. 2018;1(8):e186085.
5. Lakshmanan A, Agni M, Lieu T, Fleegler E, Kipke M, Friedlich PS, et al. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes.
2017;15(1):38.
6. Preda A, Caracostea G, Ona D, Zaharie G, Stamatian F. Association betwee maternal/newborn genetic variants, placental pathology and spontaneous preterm birth risk: a Romanian population-based study. J Matern Fetal Neonatal Med. 2020;33(7):1171-7.
7. Strauss JF, 3rd, Romero R, Gomez-Lopez N, Haymond-Thornburg H, Modi BP, Teves ME, et al. Spontaneous preterm birth: advances toward the discovery of genetic predisposition. Am J Obstet Gynecol. 2018;218(3):294-314.e2.
8. Conde-Agudelo A, Romero R, Da Fonseca E, O'Brien JM, Cetingoz E, Creasy GW, et al. Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis. Am J Obstet Gynecol. 2018;219(1):10-25.
9. Norman JE, Marlow N, Messow CM, Shennan A, Bennett PR, Thornton S, et al. Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. Lancet. 2016;387(10033):2106-16.
Cadavid AP. Aspirin: The Mechanism of Action Revisited in the Context of
Pregnancy Complications. Front Immunol. 2017;8:261.
10. Atallah A, Lecarpentier E, Goffinet F, Doret-Dion M, Gaucherand P, Tsatsaris V.
Aspirin for Prevention of Preeclampsia. Drugs. 2017;77(17):1819-31.
11. Hoffman MK, Goudar SS, Kodkany BS, Metgud M, Somannavar M, Okitawutshu J, et al. Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10220):285-93.
12. Allshouse AA, Jessel RH, Heyborne KD. The impact of low-dose aspirin on preterm birth: secondary analysis of a randomized controlled trial. J Perinatol. 2016;36(6):427-31.
13. Ibrahim ZM, Mohamed ML, Gadallah AM, Mahmoud ES, Shora HA. Low Dose Aspirin in prevention of Spontaneous Preterm Birth in Suez Canal University Hospital. Madridge J Intern Emerg Med. 2019;3(2):146-51.
14. Andrikopoulou M, Purisch SE, Handal-Orefice R, Gyamfi-Bannerman C. Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women. Am J Obstet Gynecol. 2018;219(4):399-e1.
15. UNICEF DATA: Monitoring the situation of children and women [Internet] Newyork:UNICEF.[cited 2021 Dec 2]. Avalaible from : https://data.unicef.org/country/pak/
