Pre-eclampsia remains the leading cause of maternal death in Europe and the cause of more than 500,000 infant deaths worldwide every year.
Following a recent medical breakthrough that revealed a baby’s DNA can increase the risk of their mum developing pre-eclampsia, some of the world’s leading obstetricians have announced another significant development regarding the life-threatening condition.
Pre-eclampsia causes the flow of blood through the placenta to be reduced, restricting the flow of oxygen and nutrients to the foetus which could restrict growth. It can lead to premature birth and, in extreme cases, death of both mother and baby. A family history of the condition, obesity, diabetes, high blood pressure or kidney disease increases the probability of developing the condition. Severe pre-eclampsia can develop in around two percent of pregnancies, with mild pre-eclampsia in up to six percent of women. The risk of complications is considerably higher when the disease is severe and develops early on in the pregnancy.
Professors Kypros Nicolaides and Dr Liona Poon of King’s College, London and Professor David Wright of the University of Exeter, have found that taking a low-dose aspirin before bed can significantly reduce the risk of pre-eclampsia.
The ASPRE trial was conducted at 13 maternity hospitals in the UK, Spain, Italy, Belgium, Greece, and Israel. The findings, which were announced on Wednesday at the World Congress in Foetal Medicine in Slovenia, demonstrated that administering low-dose aspirin (150 mg) led to a 62 percent reduction in the rate of pre-term pre-eclampsia, resulting in delivery before 37 weeks.
The double blind, placebo-controlled trail of 1,776 women at high risk for pre-term pre-eclampsia found a lower incidence of the condition in women taking aspirin than those taking a placebo. Pre-eclampsia occurred in 13 participants (1.6 percent) in the aspirin group, compared to 35 (4.3 percent) in the placebo group. The pregnant women were given a dose of 150mg per day from between 11 to 14 weeks of pregnancy up until 36 weeks.
The results have prompted calls for low-dose aspirin to be routinely prescribed to women at risk of the disease. Professor Nicolaides, director of the Harris Birthright Research Centre for Foetal Medicine at King’s College London and Chairman of the Foetal Medicine Foundation, says the results of the trial offer ‘definitive proof’ of the effect of aspirin:
“This extensive study is definitive proof that women can take simple measures in the first trimester of pregnancy to significantly reduce their chances of developing pre-term pre-eclampsia.”
Professor David Wright, a professor of medical statistics at the University of Exeter Medical School, hopes the results will change medic:
“Over the last ten years, we have developed new methods for assessing the risk of pre-eclampsia. We have applied these to identify women for inclusion in the ASPRE trial.
The results show that aspirin can prevent pre-eclampsia in high risk pregnancies. I hope that they will alter clinical practice and improve pregnancy outcomes for mothers and their babies.”
The team’s findings are the latest in a series of trials which have demonstrated the positive impact of taking low-dose aspirin. An analysis of more than 30 trials investigating the benefit of a dose of 50 to 150 mg of aspirin per day for the prevention of pre-eclampsia showed that such therapy resulted in a 10 percent lower incidence of the condition.
The World Health Organisation already recommends low-dose aspirin for the prevention of pre-eclampsia in women at high risk and recommends it be started before 20 weeks of pregnancy. In the US, the American College of Obstetricians and Gynaecologists recommends the use of aspirin in women with a history of pre-eclampsia in more than one pregnancy or a history of pre-eclampsia resulting in delivery before 34 weeks of gestation.
