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Poster Session 4

(977) Risk Factors for Failing Aspirin Prophylaxis for Preeclampsia Prevention: a Prospective Cohort Secondary Analysis

Friday, January 31, 2025
4:00 PM – 6:00 PM  

    Submitting Author and Presenting Author(s)

  • Bhaskari Burra, MD (she/her/hers)

    Maternal Fetal Medicine Fellow
    Mountain Area Health Education Center
    Asheville, NC, United States

    • Coauthor(s)

  • DG

    Danetta Green, MD

    Resident Physician
    Mountain Area Health Education Center
    Asheville, North Carolina, United States

  • TC

    Traci Carson, PhD

    Director of Analytics and Scholarship
    Mountain Area Health Education Center (MAHEC)
    Asheville, North Carolina, United States

  • Lisa M. Foglia, MD

    Fellowship Director
    Mountain Area Health Education Center (MAHEC)
    Asheville, North Carolina, United States

Objective: We aimed to identify demographic characteristics and risk factors associated with failure of aspirin (ASA) prophylaxis in a nulliparous population with singleton pregnancies. 

Study Design: We conducted a secondary analysis of the prospective NuMom2B cohort of 9289 nulliparous women. We included participants with a gestational age of 20 weeks’ gestation or greater. Our sample included 8741 women. The exposure of interest was ASA. The primary outcome was the development of any hypertensive disorder of pregnancy. We compared demographic factors among women who did and did not use aspirin during their pregnancy and outcomes by group.  

Results:

Patients who used aspirin during pregnancy (n=117) were older (31 vs. 27, p< 0.001), more likely to be White (87% vs. 65%, p< 0.001), non-Hispanic (87% vs. 73%, p< 0.001) and more likely to have chronic hypertension (HTN) (9% vs 3%, p< 0.001), compared to non-aspirin users (n=8624). ASA users were more likely to develop preeclampsia (11% vs 6%, p< 0.05), versus the non-aspirin group. There were no notable differences in risk factors between ASA users and non-ASA users for development of hypertensive disorders. There was no significant difference in the gestational age at delivery between the two groups. 



Within the ASA group, women who developed hypertensive disorders had a lower mean BMI (24.4 vs 27.4, p< 0.05) and were slightly older (33 vs 31, p=0.15) compared to those who did not develop hypertensive disorders. 


Conclusion: In this study, we found that there is no difference in risk factors for the development of hypertensive disorders between ASA and non-ASA users. We did find a higher incidence of hypertensive disorders in the ASA group. This is possibly due to our relatively small sample size of patients taking ASA, but also could represent a higher apriori risk in this group. The similar gestational ages at delivery amongst ASA and non-ASA also supports the theory that ASA use prevents the onset of hypertensive disorders of pregnancy by delaying the “metabolic clock” of placental maturation during pregnancy.