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Research offers recommendations for use of aspirin to prevent preeclampsia

December 16, 2015

To prevent preeclampsia, new research suggests that low-dose aspirin should be given prophylactically to all women at high risk (those with diabetes or chronic hypertension) and any woman with two or more moderate risk factors (including obesity, multiple gestation and advanced maternal age).

Preeclampsia, a potentially dangerous complication of pregnancy characterized by high blood pressure and a high level of protein in the urine or other end organ affects, complicates between three and seven percent of the births in the U.S. One in seven preterm births and one in 10 maternal deaths in the U.S. can be directly attributed to preeclampsia. Currently, the only intervention that has been shown to reduce the risk of preeclampsia is the use of prophylactic low-dose aspirin.

Erika Werner, MD, of the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island, a Care New England hospital, and an assistant professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University; Dwight Rouse, MD, of Women & Infants' Division of Maternal-Fetal Medicine, principal investigator for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network (MFMU), and a professor of obstetrics and gynecology at the Alpert Medical School; and Alisse Hausperg, MD, a chief resident at Women & Infants, have published research in the December 2015 edition of Obstetrics & Gynecology, now available online. The research is entitled 'A Cost-Benefit Analysis of Low-Does Aspirin Prophylaxis for the Prevention of Preeclampsia in the United States.'

The researchers developed a decision model to evaluate the risks, benefits and costs of four different approaches to aspirin prophylaxis -- no prophylaxis, prophylaxis per recommendations of the American College of Obstetricians and Gynecologists (only for a narrow segment of pregnant women -- namely, those with a history of preeclampsia necessitating delivery before 34 weeks gestation and those with preeclampsia in more than one prior pregnancy), prophylaxis per the U.S. Preventive Task Force recommendations, and universal prophylaxis for all women.

The researchers concluded, "Both the U.S. Preventive Task Force approach and universal prophylaxis would reduce morbidity, save lives, and lower health care costs in the United States to a much greater degree than the approach currently recommended by ACOG."
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Obstetrics & Gynecology is the official publication of the American College of Obstetricians and Gynecologists (the College). Popularly known as 'The Green Journal,' Obstetrics & Gynecology has been published since 1953. The goal of the journal is to promote excellence in the clinical practice of obstetrics and gynecology and closely related fields.

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the 12th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit.

Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the Pelvic Floor Disorders Network.

Care New England

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