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ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia

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ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia. / Wright, David; Poon, Liona C.; Rolnik, Daniel L.; Syngelaki, Argyro; Delgado, Juan Luis; Vojtassakova, Denisa; de Alvarado, Mercedes; Kapeti, Evgenia; Rehal, Anoop; Pazos, Andrea; Carbone, Ilma Floriana; Dutemeyer, Vivien; Plasencia, Walter; Papantoniou, Nikos; Nicolaides, Kypros H.

In: American Journal of Obstetrics and Gynecology, 06.09.2017.

Research output: Contribution to journalArticle

Harvard

Wright, D, Poon, LC, Rolnik, DL, Syngelaki, A, Delgado, JL, Vojtassakova, D, de Alvarado, M, Kapeti, E, Rehal, A, Pazos, A, Carbone, IF, Dutemeyer, V, Plasencia, W, Papantoniou, N & Nicolaides, KH 2017, 'ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia', American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2017.08.110

APA

Wright, D., Poon, L. C., Rolnik, D. L., Syngelaki, A., Delgado, J. L., Vojtassakova, D., ... Nicolaides, K. H. (2017). ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2017.08.110

Vancouver

Wright D, Poon LC, Rolnik DL, Syngelaki A, Delgado JL, Vojtassakova D et al. ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia. American Journal of Obstetrics and Gynecology. 2017 Sep 6. https://doi.org/10.1016/j.ajog.2017.08.110

Author

Wright, David ; Poon, Liona C. ; Rolnik, Daniel L. ; Syngelaki, Argyro ; Delgado, Juan Luis ; Vojtassakova, Denisa ; de Alvarado, Mercedes ; Kapeti, Evgenia ; Rehal, Anoop ; Pazos, Andrea ; Carbone, Ilma Floriana ; Dutemeyer, Vivien ; Plasencia, Walter ; Papantoniou, Nikos ; Nicolaides, Kypros H. / ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia. In: American Journal of Obstetrics and Gynecology. 2017.

Bibtex Download

@article{a90a2c728f3e434db8ca11858906d14a,
title = "ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia",
abstract = "Objective To examine the influence of compliance on the beneficial effect of aspirin in prevention of preterm preeclampsia in the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial. Study design This was a secondary analysis of data from the ASPRE trial. In this multicenter-study women with singleton pregnancies had screening by means of an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine-artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor) at 11-13 weeks’ gestation. Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs. placebo from 11 to 14 until 36 weeks’ gestation. Preterm preeclampsia with delivery at <37 weeks’ gestation, which was the primary outcome, occurred in 1.6{\%} (13/798) participants in the aspirin group, as compared with 4.3{\%} (35/822) in the placebo group (odds ratio in the aspirin group, 0.38; 95{\%} confidence interval, 0.20 to 0.74). The proportion of prescribed tablets taken was used as an overall measure of compliance. Logistic-regression analysis was used to estimate the effect of aspirin on the incidence of preterm preeclampsia according to compliance of <90{\%} and >90{\%}, after adjustment for the estimated risk of preterm preeclampsia at screening and the participating center. The choice of cut-off of 90{\%} was based on an exploratory analysis of the treatment effect. Logistic regression analysis was used to investigate predictors of compliance >90{\%} among maternal characteristics and medical history. Results Preterm preeclampsia occurred in 5/555 (0.9{\%}) participants in the aspirin group with compliance ≥90{\%}, in 8/243 (3.3{\%}) of participants in the aspirin group with compliance <90{\%}, in 22/588 (3.7{\%}) of participants in the placebo group with compliance ≥90{\%}, and in 13/234 (5.6{\%}) of participants in the placebo group with compliance <90{\%}. The odds ratio in the aspirin group for preterm preeclampsia was 0.24 (95{\%} confidence interval, 0.09 to 0.65) for compliance >90{\%} and 0.59 (95{\%} confidence interval, 0.23 to 1.53) for compliance <90{\%}. Compliance was positively associated with family history of preeclampsia and negatively associated with smoking, maternal age <25 years, Afro-Caribbean and South Asian racial origin, and history of preeclampsia in a previous pregnancy. Conclusions The beneficial effect of aspirin in the prevention of preterm preeclampsia appears to depend on compliance.",
keywords = "First trimester screening, Aspirin, ASPRE trial, Preeclampsia, Pyramid of pregnancy care, Compliance, Uterine artery Doppler, Mean arterial blood pressure, Placental growth factor, Pregnancy associated plasma protein-A, Prediction, Treatment effect",
author = "David Wright and Poon, {Liona C.} and Rolnik, {Daniel L.} and Argyro Syngelaki and Delgado, {Juan Luis} and Denisa Vojtassakova and {de Alvarado}, Mercedes and Evgenia Kapeti and Anoop Rehal and Andrea Pazos and Carbone, {Ilma Floriana} and Vivien Dutemeyer and Walter Plasencia and Nikos Papantoniou and Nicolaides, {Kypros H.}",
year = "2017",
month = "9",
day = "6",
doi = "10.1016/j.ajog.2017.08.110",
language = "English",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia

AU - Wright, David

AU - Poon, Liona C.

AU - Rolnik, Daniel L.

AU - Syngelaki, Argyro

AU - Delgado, Juan Luis

AU - Vojtassakova, Denisa

AU - de Alvarado, Mercedes

AU - Kapeti, Evgenia

AU - Rehal, Anoop

AU - Pazos, Andrea

AU - Carbone, Ilma Floriana

AU - Dutemeyer, Vivien

AU - Plasencia, Walter

AU - Papantoniou, Nikos

AU - Nicolaides, Kypros H.

PY - 2017/9/6

Y1 - 2017/9/6

N2 - Objective To examine the influence of compliance on the beneficial effect of aspirin in prevention of preterm preeclampsia in the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial. Study design This was a secondary analysis of data from the ASPRE trial. In this multicenter-study women with singleton pregnancies had screening by means of an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine-artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor) at 11-13 weeks’ gestation. Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs. placebo from 11 to 14 until 36 weeks’ gestation. Preterm preeclampsia with delivery at <37 weeks’ gestation, which was the primary outcome, occurred in 1.6% (13/798) participants in the aspirin group, as compared with 4.3% (35/822) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74). The proportion of prescribed tablets taken was used as an overall measure of compliance. Logistic-regression analysis was used to estimate the effect of aspirin on the incidence of preterm preeclampsia according to compliance of <90% and >90%, after adjustment for the estimated risk of preterm preeclampsia at screening and the participating center. The choice of cut-off of 90% was based on an exploratory analysis of the treatment effect. Logistic regression analysis was used to investigate predictors of compliance >90% among maternal characteristics and medical history. Results Preterm preeclampsia occurred in 5/555 (0.9%) participants in the aspirin group with compliance ≥90%, in 8/243 (3.3%) of participants in the aspirin group with compliance <90%, in 22/588 (3.7%) of participants in the placebo group with compliance ≥90%, and in 13/234 (5.6%) of participants in the placebo group with compliance <90%. The odds ratio in the aspirin group for preterm preeclampsia was 0.24 (95% confidence interval, 0.09 to 0.65) for compliance >90% and 0.59 (95% confidence interval, 0.23 to 1.53) for compliance <90%. Compliance was positively associated with family history of preeclampsia and negatively associated with smoking, maternal age <25 years, Afro-Caribbean and South Asian racial origin, and history of preeclampsia in a previous pregnancy. Conclusions The beneficial effect of aspirin in the prevention of preterm preeclampsia appears to depend on compliance.

AB - Objective To examine the influence of compliance on the beneficial effect of aspirin in prevention of preterm preeclampsia in the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial. Study design This was a secondary analysis of data from the ASPRE trial. In this multicenter-study women with singleton pregnancies had screening by means of an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine-artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor) at 11-13 weeks’ gestation. Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs. placebo from 11 to 14 until 36 weeks’ gestation. Preterm preeclampsia with delivery at <37 weeks’ gestation, which was the primary outcome, occurred in 1.6% (13/798) participants in the aspirin group, as compared with 4.3% (35/822) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74). The proportion of prescribed tablets taken was used as an overall measure of compliance. Logistic-regression analysis was used to estimate the effect of aspirin on the incidence of preterm preeclampsia according to compliance of <90% and >90%, after adjustment for the estimated risk of preterm preeclampsia at screening and the participating center. The choice of cut-off of 90% was based on an exploratory analysis of the treatment effect. Logistic regression analysis was used to investigate predictors of compliance >90% among maternal characteristics and medical history. Results Preterm preeclampsia occurred in 5/555 (0.9%) participants in the aspirin group with compliance ≥90%, in 8/243 (3.3%) of participants in the aspirin group with compliance <90%, in 22/588 (3.7%) of participants in the placebo group with compliance ≥90%, and in 13/234 (5.6%) of participants in the placebo group with compliance <90%. The odds ratio in the aspirin group for preterm preeclampsia was 0.24 (95% confidence interval, 0.09 to 0.65) for compliance >90% and 0.59 (95% confidence interval, 0.23 to 1.53) for compliance <90%. Compliance was positively associated with family history of preeclampsia and negatively associated with smoking, maternal age <25 years, Afro-Caribbean and South Asian racial origin, and history of preeclampsia in a previous pregnancy. Conclusions The beneficial effect of aspirin in the prevention of preterm preeclampsia appears to depend on compliance.

KW - First trimester screening

KW - Aspirin

KW - ASPRE trial

KW - Preeclampsia

KW - Pyramid of pregnancy care

KW - Compliance

KW - Uterine artery Doppler

KW - Mean arterial blood pressure

KW - Placental growth factor

KW - Pregnancy associated plasma protein-A

KW - Prediction

KW - Treatment effect

U2 - 10.1016/j.ajog.2017.08.110

DO - 10.1016/j.ajog.2017.08.110

M3 - Article

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

ER -

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