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Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia

Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco Matallana C, et al.

N Engl J Med. 2017 Aug 17;377(7):613-622. doi: 10.1056/NEJMoa1704559. Epub 2017 Jun 28.

Editor's comment: Prof. Jim Thornton: ASPRE trial

It has long been known that low dose aspirin (typically 75mg daily) prevents pre-eclampsia, although the effect is modest, only a 10% reduction. The ASPRE trial identified women at increased risk of pre-eclampsia using a screening algorithm and randomised then to aspirin 150mg at night or placebo from 14 weeks at the latest.  Although the screening algorithm performed somewhat less well than anticipated, the aspirin was more effective than previous trials in preventing pre-term pre-eclampsia (Odds ratio 0.38; 95% confidence interval, 0.20 - 0.74).

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Commentaries by Editor Prof. Jim Thornton