Low-dose Aspirin for Primary Prevention of Adverse Pregnancy Outcomes in
Twin Pregnancies: An Observational Cohort Study Based on Propensity
Score Matching
Abstract
Abstract Objective: We aimed to preliminarily assess whether low-dose
aspirin(LDA)is beneficial in preventing preeclampsia in twin
pregnancies. Design: An observational cohort study. Setting: Two
hospital centers in Chongqing, China. Population: 932 twin-pregnant
women. Methods: Among 932 participants, 277 in the First Affiliated
Hospital of Chongqing Medical University were routinely treated with
aspirin (100mg daily) from 12-16 weeks to 35 weeks of gestational age,
while 655 in Chongqing Health Center for Women and Children were not
taking aspirin during the whole pregnancy. We followed each subject and
the individual details were recorded. Main Outcome Measures: The main
outcome was to compare the incidence of preeclampsia in women with or
without aspirin intaking. Results: LDA significantly reduced the risk of
PE (OR: 0.48, 95% CI: 0.24-0.95, p=0.048) and <34 weeks preterm birth
(OR: 0.50, 95% CI: 0.29-0.86, p=0.013), but showed possible benefits to
lower the rate of SGA babies (OR: 0.74, 95% CI: 0.55-1.00, p=0.063).
Moreover, the risk of postpartum hemorrhage was not increased by LDA
(OR: 0.89, 95% CI: 0.35-2.26, p=1.000). Conclusions: Treatment with
low-dose aspirin in women pregnant with twins could offer some
protection against adverse pregnancy outcomes in the absence of any
significantly increased risk of postpartum hemorrhage. Funding: The
National Key Research and Development Program of China (2018YFC1002900),
and National Natural Science Foundation of China (81520108013, 81771613,
81671488, 81871189). Keywords: Twin pregnancy, low-dose aspirin,
preeclampsia, preterm birth, small for gestational age