NEONATOLOGY

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Aspirin May Help Prevent Pregnancy Loss in Women with High Inflammation

 

Inflammation has been linked to causes of infertility. As a result, a study published online in the Journal of Clinical Endocrinology and Metabolism (3 February 2017), was performed to investigate the effect of preconception-initiated low dose aspirin (LDA) on pregnancy rates, pregnancy loss, live birth rates, and inflammation during pregnancy. The investigation was a stratified secondary analysis of a multi-center, block-randomized, double-blind, placebo-controlled trial performed at 4 U.S. academic medical centers between 2007 and 2012. Study participants included healthy women 18-40 years (N=1,228) with 1-2 prior pregnancy losses actively attempting to conceive. The intervention was preconception-initiated, daily LDA (81 mg) or matching placebo taken up to six menstrual cycles attempting pregnancy and through 36 weeks’ gestation in women who conceived. The main outcome measures included confirmed pregnancy, live birth, and pregnancy loss. These outcome variables ¬†were compared between LDA and placebo, stratified by tertile of pre-conception, pre-intervention serum high sensitivity C-reactive protein (hsCRP) (low: <0.70 mg/L; mid: 0.70-<1.95 mg/L; high: >1.95 mg/L).

 

Results showed that overall, live birth occurred in 55% of women. The lowest pregnancy and live birth rates occurred among the highest hsCRP tertile receiving placebo (44% live birth). LDA increased live birth among high hsCRP women to 59% (RR: 1.35), similar to rates observed in the lower and mid-CRP tertiles. LDA did not affect clinical pregnancy or live birth in the low (live birth: 59% LDA, 54% placebo) or mid-level hsCRP tertiles (live birth: 59% LDA, 59% placebo).

 

According to the authors, in women attempting conception with elevated hsCRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates to those of women without inflammation and reduce hsCRP elevation during pregnancy. The authors added that more research is needed to confirm the findings and to examine the potential influence of inflammation in becoming pregnant and maintaining pregnancy.

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