The European Union has recently funded a large-scale trial called the
ASPRE Project that will look at the use of low-dose aspirin treatment for the prevention of preeclampsia. Recent
guidelines from the United States Preventative Services Task Force (USPSTF), American College of Obstetricians and Gynecologists (ACOG) and other country-specific guidelines have suggested that low-dose aspirin beginning as early as the second trimester of pregnancy may prevent preeclampsia among women at high risk of developing this hypertensive disorder of pregnancy.
However, the definition of "high risk" is not universally applied. The ACOG guidelines, for instance, endorse the use of low-dose aspirin for women with very high risk (i.e., preeclampsia occurred in more than one pregnancy or before 34 weeks). The USPSTF guidance adds to the definition of high risk by including women with two or more moderate risk factors such as obesity and first-time pregnancies -- which would translate to 67 times more women being eligible versus the ACOG guidelines.
Most current guidelines have been drawn from large
meta-analyses, which is a process of reviewing a lot of data from many smaller trials. This method has its limitations because it can be difficult to compare the patients studied in each trial. The ASPRE project will rely on a large scale prospective randomized control trial, which is a clinical trial in which participants are assigned randomly into a control group or one or more treatment groups. This method is used to examine the effect of interventions on particular outcomes or the recurrence of disease. The ASPRE study just finalized the recruitment of more than 33,000 pregnancies to look at the efficiency of aspirin for the prevention of preeclampsia.
While the trial based in the European Union may not have immediate clinical impact here in the US, it may provide important evidence for the ongoing aspirin debate.
In the meantime, given the availability of two fairly different healthcare provider guidance documents on the prophylaxis of aspirin, we wonder,is your doctor prescribing low-dose aspirin? Click below to tell our community...
This two-day educational program is an opportunity for perinatal health professionals and stakeholders to share information on the planning and implementation of quality improvement initiatives, and learn about evidence-based practices at the institutional, community, state and national levels.
Executive Director Eleni Tsigas and Preeclampsia Foundation volunteer and survivor Erin Gillespie (pictured above) led an important, moving discussion to share the patient perspective of maternal and neonatal health care in perinatal crises.
The Preeclampsia Foundation is a proud member of the FPQC
Hypertension in Pregnancy Toolkit Task Force, which focuses on
the reduction of short and long-term morbidity and mortality related to pregnancy hypertension in the state of Florida.
South Carolina passes maternal mortality review law
In a step forward for women's health in the state, South Carolina Gov. Nikki Haley signed a bill establishing a Maternal Morbidity and Mortality Review Committee to develop standardized reporting of and prevention strategies for maternal deaths in South Carolina.
The Committee will be critical to understanding the impact that geography, age, preexisting conditions, community education, and access to services have on maternal death. Their work also includes identifying at-risk pregnant populations for earlier prenatal care, informing education campaigns for healthcare providers, and shaping research priorities, clinical practice, and intervention strategies to reduce maternal deaths.
The Preeclampsia Foundation has been a strong supporter of state-level maternal mortality and morbidity review committees, which help to determine contributing factors to the loss or near-loss of moms in our communities. For instance, in the states of California and Florida, perinatal quality collaborative groups used data from state-level maternal mortality reviews to build preeclampsia toolkits that include checklists, resources and protocols that address the main contributing factors in maternal loss and illness.
Look for more states to deploy maternal mortality initiatives as we continue to advocate for closer inspection of preventable deaths and near misses.
Save the Date: Preeclampsia and HELLP Syndrome Patient Advocates Summit
Calling all families affected by preeclampsia, eclampsia and HELLP syndrome! You are invited to join us at the Preeclampsia and HELLP Syndrome Patient Advocates Summit.
Date: October 14-16, 2016
Location: Lake Buena Vista Palace
Do you want to make a difference in your community? Meet other survivors from around the country? Find out how to get started volunteering to further preeclampsia education, public awareness and research?
Then join us at the Lake Buena Vista Palace in Orlando, FL to bring our voices together for the collective good.
Registration is free and includes meals during the conference. Participants are responsible for their own travel and lodging to Orlando. Bring the family and turn it into a Disney World vacation!
Attendees will learn how to take action and build preeclampsia awareness and education in our local communities as well as meet other amazing advocates from across the country.