The Safety of Low-Dose Aspirin on the Mode of Delivery: Secondary Analysis of the Effect of Aspirin in Gestation and Reproduction Randomized Controlled Trial

Allison A. Eubanks; Carrie J. Nobles; Sunni L. Mumford; Keewan Kim; Micah J. Hill; Alan H. Decherney; Lindsey A. Sjaarda; Aijun Ye; Jeannie G. Radoc; Neil J. Perkins; Robert M. Silver; Enrique F. Schisterman

doi:10.1055/s-0040-1718581

American Journal of Perinatology, Table of Contents

Am J Perinatol 2022; 39(06): 658-665
DOI: 10.1055/s-0040-1718581

Original Article

The Safety of Low-Dose Aspirin on the Mode of Delivery: Secondary Analysis of the Effect of Aspirin in Gestation and Reproduction Randomized Controlled Trial

Authors

Allison A. Eubanks

¹Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland
Carrie J. Nobles

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Sunni L. Mumford

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Keewan Kim

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Micah J. Hill

³Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Alan H. Decherney

³Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Lindsey A. Sjaarda

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Aijun Ye

⁴Glotech, Inc., Rockville, Maryland
Jeannie G. Radoc

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Neil J. Perkins

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Robert M. Silver

⁵Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
Enrique F. Schisterman

²Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

Abstract

Objective This study aimed to examine whether prenatal low-dose aspirin (LDA) therapy affects risk of cesarean versus vaginal delivery.

Study Design This study is a secondary analysis of the randomized clinical effects of aspirin in gestation and reproduction (EAGeR) trial. Women received 81-mg daily aspirin or placebo from preconception to 36 weeks of gestation. Mode of delivery and obstetric complications were abstracted from records. Log-binomial regression models estimated relative risk (RR) of cesarean versus vaginal delivery. Data were analyzed among the total preconception cohort, as well as restricted to women who had a live birth.

Results Among 1,228 women, 597 had a live birth. In the intent-to-treat analysis, preconception-initiated LDA was not associated with risk of cesarean (RR = 1.02; 95% confidence interval [CI]: 0.98–1.07) compared with placebo. Findings were similar in just women with a live birth and when accounting prior cesarean delivery and parity.

Conclusion Preconception-initiated daily LDA was not associated with mode of delivery among women with one to two prior losses.

Key Points

Aspirin was not associated with risk of cesarean section.
Aspirin was not associated with mode of delivery.
No increased risk of bleeding with use of aspirin.

Keywords

low-dose aspirin - spontaneous vaginal delivery - cesarean delivery - induction - placentation

Full Text

References

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