The Effect of Preconception-Initiated Low-Dose Aspirin on Human Chorionic Gonadotropin–Detected Pregnancy, Pregnancy Loss, and Live Birth

  title={The Effect of Preconception-Initiated Low-Dose Aspirin on Human Chorionic Gonadotropin–Detected Pregnancy, Pregnancy Loss, and Live Birth},
  author={Ashley I. Naimi and Neil Perkins and Lindsey A. Sjaarda and Sunni L. Mumford and Robert William Platt and Robert M Silver and Enrique F. Schisterman},
  journal={Annals of Internal Medicine},
  pages={595 - 601}
BACKGROUND A previous large randomized trial indicated that preconception-initiated low-dose aspirin (LDA) therapy did not have a positive effect on pregnancy outcomes. However, this trial was subject to nonadherence, which was not taken into account by the intention-to-treat approach. OBJECTIVE To estimate per protocol effects of preconception-initiated LDA on pregnancy loss and live birth. DESIGN The EAGeR (Effects of Aspirin on Gestation and Reproduction) trial was used to construct a… 



Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial

In women attempting conception with elevated hs CRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates compared with women without inflammation and reduce hsCRP elevation during pregnancy.

Complications and Safety of Preconception Low-Dose Aspirin Among Women With Prior Pregnancy Losses

Although rare but serious complications resulting from low-dose aspirin cannot be ruled out, preconception low- dose aspirin appears to be well tolerated by women trying to conceive, women who become pregnant, and by their fetuses and neonates.

A randomised trial to evaluate the effects of low-dose aspirin in gestation and reproduction: design and baseline characteristics.

The purpose of the EAGeR trial was to determine whether preconception-initiated LDA improves livebirth rates in women with one to two prior losses, and the primary outcome was the cumulative livebirth rate over the trial period.

Incidence of early loss of pregnancy.

The total rate of pregnancy loss after implantation, including clinically recognized spontaneous abortions, was 31 percent and most of the 40 women with unrecognized early pregnancy losses had normal fertility, since 95 percent of them subsequently became clinically pregnant within two years.

ACOG Committee Opinion No. 743: Low-Dose Aspirin Use During Pregnancy.

  • Medicine
    Obstetrics and gynecology
  • 2018
In the absence of high risk factors for preeclampsia, current evidence does not support the use of prophylactic low-dose aspirin for the prevention of early pregnancy loss, fetal growth restriction, stillbirth, or preterm birth.

Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss: A Secondary Analysis of a Randomized Clinical Trial.

Among women with 1 or 2 prior pregnancy losses, nausea and vomiting were common very early in pregnancy and were associated with a reduced risk for pregnancy loss.

Aspirin and Reproductive Outcomes

The reader should be able to recall the varied reaction to low- and high-dose aspirin, and explain its biochemical roles in prostaglandin production and actions, its role in prevention and treatment of poor pregnancy outcomes, and the potential of congenital malformations and other adverse outcomes.

Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia.

This review does not support the use of anticoagulants in women with unexplained recurrent miscarriage and needs to be assessed in further randomised controlled trials; at present there is no evidence of a beneficial effect.