Poster Session 4
Ukachi N. Emeruwa, MD, MPH (she/her/hers)
Assistant Professor/Women's Reproductive Health Research Scholar
University of California, San Diego
San Diego, California, United States
Chaukim Peters, BA
St. George's University School of Medicine
St. George's, Virgin Islands, U.S., U.S. Virgin Islands
Kysha Mercader, BS
University of California, San Diego School of Medicine
La Jolla, California, United States
Minhazur R. Sarker, MD (he/him/his)
Fellow
University of California, San Diego
San Diego, California, United States
Elizabeth Nicole Teal, MD, MPH (she/her/hers)
Assistant Professor, Division of Maternal-Fetal Medicine
University of California, San Diego
San Diego, California, United States
Gregory W. Poorman, MPH
Dorsata, Inc.
Arlington, Virginia, United States
Barbara Levy, MD
Dorsata, Inc.
Arlington, Virginia, United States
Patrick Edmundson, BA
Dorsata, Inc.
Arlington, Virginia, United States
Maryam Tarsa, MD
Professor
University of California San Diego
San Diego, California, United States
Cynthia Gyamfi-Bannerman, MD, MS (she/her/hers)
Professor and Chair
University of California, San Diego
San Diego, California, United States
Low dose aspirin (LDA) mitigates antenatal preeclampsia risk. Data is scarce regarding LDA effectiveness in preventing de novo postpartum hypertension (dnPPHTN), a growing contributor to maternal morbidity and mortality. We investigated the association between antenatal LDA prescription and dnPPHTN in a diverse multicenter cohort.
Study Design:
We conducted a retrospective cohort study of patient data extracted from a multicenter electronic medical record system, including patients delivering from 2017 to 2024 from 90 locations and ~320 providers. Patients who met ACOG criteria for LDA 81 mg once daily throughout pregnancy for preeclampsia risk reduction were included in the analysis. Exclusion criteria were: preexisting HTN, congenital heart disease, or pregnancy-related HTN in the index pregnancy. Patients were grouped by LDA exposure (based on provider completion of prescription/recommendation). The primary outcome was dnPPHTN incidence, defined as “postpartum HTN” recorded at the postpartum encounter or on the delivery outcome form. We fit logistic regression models for dnPPHTN with unadjusted and adjusted odds ratios (OR, aOR) presented as measures of association.
Results:
A total of 15,899 patients met criteria for LDA for preeclampsia risk reduction and did not develop hypertension antenatally; of those 10209 (64%) had been appropriately prescribed LDA. The overall incidence of dnPPHTN was 2.9% (n=466). (Table 1) LDA-exposed patients had an increased odds of dnPPHTN compared to LDA-unexposed patients (OR 1.4, 95% CI 1.2,1.7). After controlling for baseline differences in clinically-relevant risk factors and other clinical characteristics (Table 2), this association persisted (aOR 1.4, 95% CI 1.1,1.8). Patients at increased risk of preeclampsia by ACOG criteria who are prescribed LDA remain at elevated risk for HTN in the postpartum period. Given limitations in assessing adherence and unmeasured confounders, prospective trials may help elucidate whether aspirin serves any preventative role beyond delivery.
Conclusion:
