The impact of low-dose aspirin on markers of inflammation and placental function: an ancillary study of the ASPIRIN trial

Abstract

Objective

To determine the impact of low-dose aspirin (81 mg) on markers of maternal inflammation and placental function.

Setting

Rural Southern India

Population

Nulliparous women with a singleton pregnancy dated by ultrasound who were enrolled in the ASPIRIN (Aspirin Supplementation for Pregnancy Indicated risk Reduction In Nulliparas) Trial.

Methods

We performed a case-control study to elucidate the impact of low dose aspirin (LDA) on markers of placental function and maternal inflammation among women who delivered prematurely compared to term controls in women enrolled in the ASPIRIN trial. Women were prospectively enrolled in an ancillary observational trial wherein maternal serum was collected and measured between 10 to 13 weeks and 17 to 21 weeks of gestation after initiation of aspirin or an identical placebo.

Results

From 2016-18 with a total of 666 n women enrolled in this ancillary trial of whom 269 were selected for analyte analysis. Women who received LDA had lower levels of Alpha Feto-Protein (AFP) at 10 to 13 weeks than women who received placebo (Placebo) (LDA 18.3 ng/mL vs 21.4 ng/mL -P 0.001). AFP was similar between the two groups at 17 to 21 weeks. No other differences were seen in C-Reactive protein or Anti-Mullerian Hormone.

Conclusion

Low-dose aspirin administration lowers AFP early in pregnancy.

Keywords:

• Maternal serum alpha-fetoprotein (MSAFP)
• preterm birth
• aspirin
• preclampsia
• fetal growth restriction

Author contributions

RA conceived of the manuscript and wrote the first draft with input from MSS, MKH and SSG. AK, RA, SSV, MSS and SSG oversaw study implementation, data collection and quality monitoring. RA, AK, and MSS performed the statistical analyses. All authors reviewed and approved the final manuscript.

Clinical trial registration

ClinicalTrials.gov, NCT02409680, and the Clinical

Trial Registry-India, CTRI/2016/05/006970.

Reprints: Reprints will not be provided.

Disclosure statement

The authors report no conflict of interest