Aspirin Found Generally Not Effective in Reducing Pregnancy Loss

Enrique F. Schisterman, Ph.D. Chief and Senior Investigator Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854 MedicalResearch.com Interview with:
Enrique F. Schisterman, Ph.D.
Chief and Senior Investigator
Epidemiology Branch, DIPHR
Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854

MedicalResearch.com: What are the main findings of the study?

Dr. Schisterman: Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases. For the total number of women in the study, 13 percent of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12 percent who took the placebo. Ultimately, 58 percent of women taking aspirin and 53 percent of the placebo group got pregnant and later gave birth.

However, additional research is needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy. Among this group, 78 percent of those who took aspirin became pregnant, compared with 66 percent of those who took the placebo. For this subset of women, 62 percent of the aspirin group and 53 percent of the placebo group gave birth.


MedicalResearch.com: Were any of the findings unexpected?

Dr. Schisterman: We hypothesized that aspirin therapy might increase the conception rate by increasing blood flow to the uterus. Therefore our findings were not unexpected. However, we are excited by how dramatic the difference in the live birth rate is, particularly the almost 10% difference in live birth rates between women who took aspirin and placebo in the group of women who had experienced a single, recent pregnancy loss.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Schisterman: Our data do not support the general use of low-dose aspirin to decrease pregnancy loss or increase live birth rates. We found that daily low-dose aspirin started before conception was not associated with an increase in live births or a decrease in pregnancy loss in women with one to two previous losses. However, it was associated with an increased rate of positive urine pregnancy tests and a nearly 10% increase in live birth rate in women with a single pregnancy loss at less than 20 weeks’ gestation during the previous year. Because of the low cost, availability, and apparent safety of low-dose aspirin, these findings should prompt further investigation into its effects on fecundity and implantation.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Schisterman: Because we hypothesized that aspirin therapy might increase the conception rate by increasing blood flow to the uterus, we call for for additional research to determine if aspirin therapy might be helpful for improving fertility in other subgroups as well, such as women who can’t establish a pregnancy because the embryo fails to implant in the uterus.

Citation:

Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial
Dr Enrique F Schisterman PhD,Prof Robert M Silver MD,Laurie L Lesher MBA,Prof David Faraggi PhD,Prof Jean Wactawski-Wende PhD,Prof Janet M Townsend MD,Anne M Lynch MD,Neil J Perkins PhD,Sunni L Mumford PhD,Noya Galai PhD
The Lancet – 2 April 2014
DOI: 10.1016/S0140-6736(14)60157-4