IMEMR
66.92
Volume 1, Issue 4 (2020)                   J Clinic Care Skill 2020, 1(4): 159-164 | Back to browse issues page
Article Type:
Original Research |

Print XML PDF HTML


History

How to cite this article
Vanda R, Aramesh S, Sadeghian M, Ghatee M, Ghaffari P. Effect of Aspirin on Pre-eclampsia and Fetal Growth Restriction in Obese Pregnant Women: A Randomized Controlled Clinical Trial. J Clinic Care Skill 2020; 1 (4) :159-164
URL: http://jccs.yums.ac.ir/article-1-77-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Gynecology & Obstetrics Department, Yasuj University of Medical Sciences, Yasuj, Iran
2- Gynecology & Obstetrics Department, Valiasr Hospital, Bafgh, Iran
3- Cellular & Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
* Corresponding Author Address: (pari.ghffari@gmail.com)
Abstract   (1960 Views)
Aim(s): Obesity in pregnant women is a serious health problem that has many complications such as pre-eclampsia and fetal growth restriction (FGR). The aim of the present study was to evaluate the effect of aspirin on prevalence of pre-eclampsia and FGR in obese pregnant women.
Materials & Methods: This randomized controlled clinical trial was conducted on 187 pregnant women referring to birth center of Mofatteh Clinic, Yasuj University of Medical Sciences, Yasuj, Iran in 2017-2018.
The subjects were selected using purposive sampling method and randomly divided into two groups; intervention group (n=89) and control group (n=98). The intervention group received 80mg/day aspirin and the control group received placebo at 13-20 weeks of gestation until 34 weeks of pregnancy. Data were analyzed by SPSS 21 software using Chi square test.
Findings: The prevalence of pre-eclampsia (1.1 vs. 11.2) and FGR (3.4 vs. 21.4) were significantly lower in the intervention group compared to the control group (p<0.05).
Conclusion: Administration of 80mg/daily of aspirin from 13-20 weeks of gestation in obese pregnant women reduces the incidence of pre-eclampsia and FGR, which could support the positive role of aspirin in preventing pre-eclampsia and FGR.
Keywords:

References
1. NICE Clinical Guidelines. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children [Internet]. London: National Institute for Health and Clinical Excellence (UK); 2006 [cited 2009 Dec 1]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22497033. [link]
2. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307(5):491-7. [link] [DOI:10.1001/jama.2012.39] [PMID]
3. Ramsey PS, Schenken RS, Pi-Sunyer FX. Obesity in pregnancy: Complications and maternal management [Internet]. Up To Date; 2017 [cited 2009 Dec 1]. Available from: https://www uptodate com/contents/obesity-inpregnancy-complications-and-maternal-management. [link]
4. Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight-48 states, New York City, and District of Columbia, 2011-2015. MMWR Morb Mortal Wkly Rep. 2018;66(51-52):1402-7. [link] [DOI:10.15585/mmwr.mm665152a3] [PMID] [PMCID]
5. Hajian-Tilaki KO, Heidari B. Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach. Obes Rev. 2007;8(1):3-10. [link] [DOI:10.1111/j.1467-789X.2006.00235.x] [PMID]
6. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation (WHO Technical Report Series 894) [Internet]. Geneva: WHO; 2000 [cited 2009 Dec 1]. Available from: https://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/ [link]
7. Delhaes F, Giza SA, Koreman T, Eastabrook G, McKenzie CA, Bedell S, et al. Altered maternal and placental lipid metabolism and fetal fat development in obesity: Current knowledge and advances in non-invasive assessment. Placenta. 2018;69:118-24. [link] [DOI:10.1016/j.placenta.2018.05.011] [PMID]
8. Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017;356:j1. [link] [DOI:10.1136/bmj.j1] [PMID] [PMCID]
9. Robinson HE, O'connell CM, Joseph KS, McLeod NL. Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol. 2005;106(6):1357-64. [link] [DOI:10.1097/01.AOG.0000188387.88032.41] [PMID]
10. LeFevre ML. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(11):819-26. [link] [DOI:10.7326/M14-1884] [PMID]
11. Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM. Prevalence of maternal obesity in an urban center. Am J Obstet Gynecol. 2002;187(5):1189-93. [link] [DOI:10.1067/mob.2002.127125] [PMID]
12. Cnattingius S, Villamor E, Johansson S, Bonamy AKE, Persson M, Wikström AK, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309(22):2362-70. [link] [DOI:10.1001/jama.2013.6295] [PMID]
13. Norgard NB. Obesity and altered aspirin pharmacology. Clin Pharmacokinet. 2018;57(6):663-72. [link] [DOI:10.1007/s40262-017-0611-8] [PMID]
14. Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using low‐dose aspirin: a meta‐analysis. Ultrasound Obstet Gynecol. 2013;41(5):491-9. [link] [DOI:10.1002/uog.12421] [PMID]
15. Rolnik DL, Wright D, Poon LC, O'gorman N, Syngelaki A, de Paco Matallana C, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017;377(7):613-22. [link] [DOI:10.1056/NEJMoa1704559] [PMID]
16. Roberge S, Bujold E, Nicolaides KH. Aspirin for the prevention of preterm and term preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol. 2018;218(3):287-93. e1. [link] [DOI:10.1016/j.ajog.2017.11.561] [PMID]
17. Bujold E, Roberge S, Nicolaides KH. Low‐dose aspirin for prevention of adverse outcomes related to abnormal placentation. Prenat Diagn. 2014;34(7):642-8. [link] [DOI:10.1002/pd.4403] [PMID]
18. Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(2):110-20. e6. [link] [DOI:10.1016/j.ajog.2016.09.076] [PMID]
19. Vainio M, Kujansuu E, Koivisto AM, Maenpaa J. Bilateral notching of uterine arteries at 12-14 weeks of gestation for prediction of hypertensive disorders of pregnancy. Acta Obstet Gynecol Scand. 2005;84(11):1062-7. [link] [DOI:10.1111/j.0001-6349.2005.00889.x] [PMID]
20. Redman CW. Hypertension in pregnancy: the NICE guidelines. Heart. 2011;97(23):1967-9. [link] [DOI:10.1136/heartjnl-2011-300949] [PMID]
21. Ebrashy A, Ibrahim M, Marzook A, Yousef D. Usefulness of aspirin therapy in high-risk pregnant women with abnormal uterine artery Doppler ultrasound at 14-16 weeks pregnancy: randomized controlled clinical trial. Croat Med J. 2005;46(5):826-31. [link]
22. Hirsh J, Guyatt G, Albers GW, Harrington R, Schünemann HJ. Executive summary: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2008;133(6 Suppl):71S-109S. [link] [DOI:10.1378/chest.08-0693] [PMID]
23. August P, Jeyabalan A. Preeclampsia: Prevention [Internet]. Up To Date; 2018 [cited 2009 Dec 1]. Available from: https://www.uptodate.com/contents/preeclampsia-prevention. [link]
24. Foroozanfard F, Asemi Z, Bazarganipour F, Taghavi SA, Allan H, Aramesh S. Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study. Gynecol Endocrinol. 2020;36(1):61-5. [link] [DOI:10.1080/09513590.2019.1631278] [PMID]
25. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd Edition. New York: McGraw Hill; 2010. [link]
26. Group EC. ECPPA: randomised trial of low dose aspirin for the prevention of maternal and fetal complications in high risk pregnant women. Br J Obstet Gynaecol. 1996;103(1):39-47. [link] [DOI:10.1111/j.1471-0528.1996.tb09513.x] [PMID]
27. Bujold E, Morency AM, Roberge S, Lacasse Y, Forest JC, Giguère Y. Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal uterine artery Doppler: a systematic review and meta-analysis. J Obstet Gynaecol Can. 2009;31(9):818-26. [link] [DOI:10.1016/S1701-2163(16)34300-6]
28. Baschat A, Poon LY, Blitzer M, Nicolaides K, Harman C. OC08.05: Impact of 1st trimester aspirin on population prevalence of pre‐eclampsia. Ultrasound Obstet Gynecol. 2009;34(S1):14. [link] [DOI:10.1002/uog.6499]
29. Vainio M, Kujansuu E, Iso‐Mustajärvi M, Mäenpää J. Low dose acetylsalicylic acid in prevention of pregnancy‐induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches. BJOG. 2002;109(2):161-7. [link] [DOI:10.1111/j.1471-0528.2002.01046.x] [PMID]
30. Tanaka K, Matsushima M, Izawa T, Furukawa S, Kobayashi Y, Iwashita M. Influence of maternal obesity on fetal growth at different periods of pregnancies with normal glucose tolerance. J Obstet Gynaecol Res. 2018;44(4):691-6. [link] [DOI:10.1111/jog.13575] [PMID]
31. Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402-14. [link] [DOI:10.1097/AOG.0b013e3181e9322a] [PMID]
32. Harrington K, Kurdi W, Aquilina J, England P, Campbell S. A prospective management study of slow‐release aspirin in the palliation of uteroplacental insufficiency predicted by uterine artery Doppler at 20 weeks. Ultrasound Obstet Gynecol. 2000;15(1):13-8. [link] [DOI:10.1046/j.1469-0705.2000.00002.x] [PMID]
33. Atarod Z, Rahman Pourzanjani H, Hosseinzadeh M, Khalilian AR. Evaluation of the effect of low doses aspirin in prevention of pre-eclampsia and primipara. J Mazandaran Univ Med Sci. 2003;13(39):36-40. [Persian] [link]
34. Yu CK, Papageorghiou AT, Parra M, Dias RP, Nicolaides KH. Randomized controlled trial using low‐dose aspirin in the prevention of pre‐eclampsia in women with abnormal uterine artery Doppler at 23 weeks' gestation. Ultrasound Obstet Gynecol. 2003;22(3):233-9. [link] [DOI:10.1002/uog.218] [PMID]
35. Ruano R, Fontes RS, Zugaib M. Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials. Clinics. 2005;60(5):407-14. [link] [DOI:10.1590/S1807-59322005000500010] [PMID]