Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study
Kim-Seng Law,1– 3 Tien-Yung Wei1 1Department of Obstetrics and Gynecology, Tung’s Taichung Metro Harbor Hospital, Taichung, Taiwan; 2Department of Nursing, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; 3Department of Life Science, National Chung Hsing University, Taichun...
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Dove Medical Press
2021
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oai:doaj.org-article:825cc3109cc54958a8f2c8481605722e2021-11-11T18:22:26ZEffect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study1179-1411https://doaj.org/article/825cc3109cc54958a8f2c8481605722e2021-11-01T00:00:00Zhttps://www.dovepress.com/effect-of-low-dose-aspirin-in-preventing-early-onset-preeclampsia-in-t-peer-reviewed-fulltext-article-IJWHhttps://doaj.org/toc/1179-1411Kim-Seng Law,1– 3 Tien-Yung Wei1 1Department of Obstetrics and Gynecology, Tung’s Taichung Metro Harbor Hospital, Taichung, Taiwan; 2Department of Nursing, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; 3Department of Life Science, National Chung Hsing University, Taichung, TaiwanCorrespondence: Kim-Seng LawTung’s Taichung Metro Harbor Hospital, 699 Taiwan Boulevard, Section 8, Wuchi, Taichung City, 435, TaiwanTel +886 916120758Fax +886 26582000Email kimsenglaw@gmail.comPurpose: To evaluate the effect of low-dose aspirin on preventing early-onset preeclampsia during first-trimester screening using maternal factors and biochemistry.Patients and Methods: This study was a retrospective cohort study of pregnant women with singleton pregnancies at a gestational age of 11– 13+6 weeks from May 2017 to August 2019. Serum pregnancy-associated plasma protein A (PAPP-A)/placental growth factor (PLGF) and maternal demographic and clinical characteristics were collected and analyzed using a logistic regression model with a preset detection rate of 74% and a 10% false-positive rate. Low-dose aspirin was initiated for those screened positive for the prevention of early-onset preeclampsia.Results: Of the 805 women who underwent preeclampsia screening, 78 were screened positive for early-onset preeclampsia. With a preset detection rate of 74% and a 10% false-positive rate, there were a total of 28 women with preeclampsia, of which 11 developed preterm preeclampsia (< 37 GA) and three had early-onset preeclampsia with 72% and 75% sensitivity and specificity of 93% and 91%, respectively, resulting in an estimated 95% risk reduction for early-onset preeclampsia. Early-onset preeclampsia had lower serum PLGF (0.29 multiple of the median [MoM], range 0.1– 0.67) compared with preterm preeclampsia (0.74 MoM, range 0.1– 2.26). PLGF remains the only predictor of early-onset preeclampsia, while mean arterial pressure and chronic hypertension are predictors of preterm preeclampsia using multivariate regression. No variables accurately predicted the development of early-onset preeclampsia with the initiation of low-dose aspirin before the gestational age of 16 weeks.Conclusion: A remarkable reduction in early-onset preeclampsia was observed with early initiation of low-dose aspirin in those screened positive for maternal characteristics and serum PAPP-A/PLGF.Keywords: low-dose aspirin, placental growth factor, preeclampsia, pregnancy-associated plasma, proteinLaw KSWei TYDove Medical Pressarticlelow-dose aspirinplacental growth factorpreeclampsiapregnancy-associated plasmaproteinGynecology and obstetricsRG1-991ENInternational Journal of Women's Health, Vol Volume 13, Pp 1095-1101 (2021) |
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low-dose aspirin placental growth factor preeclampsia pregnancy-associated plasma protein Gynecology and obstetrics RG1-991 |
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low-dose aspirin placental growth factor preeclampsia pregnancy-associated plasma protein Gynecology and obstetrics RG1-991 Law KS Wei TY Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
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Kim-Seng Law,1– 3 Tien-Yung Wei1 1Department of Obstetrics and Gynecology, Tung’s Taichung Metro Harbor Hospital, Taichung, Taiwan; 2Department of Nursing, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; 3Department of Life Science, National Chung Hsing University, Taichung, TaiwanCorrespondence: Kim-Seng LawTung’s Taichung Metro Harbor Hospital, 699 Taiwan Boulevard, Section 8, Wuchi, Taichung City, 435, TaiwanTel +886 916120758Fax +886 26582000Email kimsenglaw@gmail.comPurpose: To evaluate the effect of low-dose aspirin on preventing early-onset preeclampsia during first-trimester screening using maternal factors and biochemistry.Patients and Methods: This study was a retrospective cohort study of pregnant women with singleton pregnancies at a gestational age of 11– 13+6 weeks from May 2017 to August 2019. Serum pregnancy-associated plasma protein A (PAPP-A)/placental growth factor (PLGF) and maternal demographic and clinical characteristics were collected and analyzed using a logistic regression model with a preset detection rate of 74% and a 10% false-positive rate. Low-dose aspirin was initiated for those screened positive for the prevention of early-onset preeclampsia.Results: Of the 805 women who underwent preeclampsia screening, 78 were screened positive for early-onset preeclampsia. With a preset detection rate of 74% and a 10% false-positive rate, there were a total of 28 women with preeclampsia, of which 11 developed preterm preeclampsia (< 37 GA) and three had early-onset preeclampsia with 72% and 75% sensitivity and specificity of 93% and 91%, respectively, resulting in an estimated 95% risk reduction for early-onset preeclampsia. Early-onset preeclampsia had lower serum PLGF (0.29 multiple of the median [MoM], range 0.1– 0.67) compared with preterm preeclampsia (0.74 MoM, range 0.1– 2.26). PLGF remains the only predictor of early-onset preeclampsia, while mean arterial pressure and chronic hypertension are predictors of preterm preeclampsia using multivariate regression. No variables accurately predicted the development of early-onset preeclampsia with the initiation of low-dose aspirin before the gestational age of 16 weeks.Conclusion: A remarkable reduction in early-onset preeclampsia was observed with early initiation of low-dose aspirin in those screened positive for maternal characteristics and serum PAPP-A/PLGF.Keywords: low-dose aspirin, placental growth factor, preeclampsia, pregnancy-associated plasma, protein |
format |
article |
author |
Law KS Wei TY |
author_facet |
Law KS Wei TY |
author_sort |
Law KS |
title |
Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
title_short |
Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
title_full |
Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
title_fullStr |
Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
title_full_unstemmed |
Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population—A Retrospective Cohort Study |
title_sort |
effect of low-dose aspirin in preventing early-onset preeclampsia in the taiwanese population—a retrospective cohort study |
publisher |
Dove Medical Press |
publishDate |
2021 |
url |
https://doaj.org/article/825cc3109cc54958a8f2c8481605722e |
work_keys_str_mv |
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