Low-dose aspirin improves reproductive outcomes in women with pregnancy loss

Preconception use of low-dose aspirin (LDA) at least 4 days per week is associated with better reproductive outcomes for women who have had one or two pregnancy losses, suggests a study. Increasing adherence to daily LDA may help improve effectiveness.

The Effects of Aspirin on Gestation and Reproduction (EAGER) trial was used to form a prospective cohort for a posthoc analysis in four university medical centres in the US. A total of 1,227 women aged 18 to 40 years who had one or two previous pregnancy losses and were attempting pregnancy were included in this study.

The authors assessed adherence to LDA or placebo by measuring pill bottle weights at regular intervals during follow-up. Human chorionic gonadotropin (hCG)-detected pregnancies, pregnancy losses, and live births, determined by pregnancy tests and medical records, were the primary outcomes.

Adherence to LDA for 5 of 7 days per week resulted in eight more hCG-detected pregnancies (95 percent confidence interval [CI], 4.64–10.96), 15 more live births (95 percent CI, 7.65–21.15), and six fewer pregnancy losses (95 percent CI, –12.00 to –0.20) for every 100 women in the trial compared to placebo.

In addition, postconception initiation of LDA therapy resulted in a decrease in the estimated effects relative to placebo. Effects were also obtained in a minimum of 4 of 7 days per week.

“The EAGeR trial data for this study were analysed as observational data, thus are subject to the limitations of prospective observational studies,” the authors said.