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#Grand Rounds

Has the USPSTF Aspirin Guidance Reduced the Incidence of Recurrent Preeclampsia?

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BACKGROUND AND PURPOSE: 

  • The USPSTF has issued recommendations regarding the use of preventative low-dose aspirin for women at high risk for preeclampsia (see ‘Related ObG Topics’ below) 
  • Tolcher et al. (AJOG, 2017) assessed the impact of this USPSTF recommendation on the prevention of recurrent preeclampsia 

METHODS: 

  • Retrospective cohort study 
  • Single academic institution database from August 2011 through June 2016 
  • Women were divided into two cohorts: 
    • Before 2014 release date  
    • After 2014 release date  
  • Relative and adjusted risk were calculated using multivariate analyses 

RESULTS: 

  • Data on of 17,256 deliveries was included with 417 women identified with history of prior preeclampsia  
  • Many variables differed between cohorts: proportion of Hispanic women, payment method, and type 1 diabetes prevalence 
  • Risk factors for recurrent preeclampsia included maternal age >35 y/o, Medicaid insurance, type 2 diabetes, and chronic hypertension 
  • After adjusting for cofounders, the risk of recurrent preeclampsia was decreased by 30% in the group following the release of the 2014 USPSTF recommendations 
    • adjusted relative risk, 0.70; 95% CI 0.52-0.95 

CONCLUSION: 

  • The USPSTF recommendations appears to have decreased rates of recurrent preeclampsia 

Learn More – Primary Sources:  

Impact of USPSTF recommendations for aspirin for prevention of recurrent preeclampsia

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Related ObG Topics:

ASPRE Trial: A Combined Risk Algorithm and Use of Aspirin to Prevent Preterm Preeclampsia
Aspirin Treatment for Women at Risk for Preeclampsia – ACOG and USPSTF Recommendations  
Diagnosing Preeclampsia – Key Definitions and ACOG Guidelines

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