The prevalence and perinatal repercussions of preeclampsia after the implementation of a prophylaxis protocol with aspirin

Maria Isabel M P Cardoso; Karina B de C Rezende; Fabio G Da Matta; Cláudia Saunders; Fernanda F O Cardoso; Ivo B Costa Junior; Luiza B Gama; Joffre Amim Jr; Rita G Bornia

doi:10.1016/j.preghy.2023.06.001

The prevalence and perinatal repercussions of preeclampsia after the implementation of a prophylaxis protocol with aspirin

Pregnancy Hypertens. 2023 Sep:33:17-21. doi: 10.1016/j.preghy.2023.06.001. Epub 2023 Jun 14.

Authors

Maria Isabel M P Cardoso¹, Karina B de C Rezende², Fabio G Da Matta³, Cláudia Saunders¹, Fernanda F O Cardoso⁴, Ivo B Costa Junior⁵, Luiza B Gama⁶, Joffre Amim Jr¹, Rita G Bornia¹

Affiliations

¹ Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Professional Master Perinatal Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
² Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Clinical Medicine Postgraduate Program, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: karina@me.ufrj.br.
³ Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Professional Master Perinatal Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Pedro Ernesto University Hospital, Rio de Janeiro State University, Brazil.
⁴ Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Pedro Ernesto University Hospital, Rio de Janeiro State University, Brazil.
⁵ Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁶ Professional Master Perinatal Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

PMID: 37327650
DOI: 10.1016/j.preghy.2023.06.001

Abstract

Objectives: To evaluate the prevalence and perinatal repercussions of preeclampsia (PE) after the implementation of a prophylaxis protocol with aspirin in singleton pregnancy at Maternity School of Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (2015-2106).

Methodology: PE prevalence according to gestational age (GA) and the prevalence ratio (PR) between PE and prematurity, small for gestational age (SGA), and fetal death were calculated in patients assisted during 2015 and 2016.

Results: PE occurred in 373(10.75%) of 3468 investigated cases, where PE < 37 weeks was of 2.79% and PE greater than 37 weeks was of 7.95%. A total of 413 (11.9%) prematurity cases, 320 SGA (9.22%), and 50 fetal deaths (1.44%) occurred. In the PE group, 97 premature newborns (PR 0.90) and 51 SGA (PR 1.16) were born, and two fetal deaths occurred (PR 7.46). Concerning PE < 37 weeks, 27 SGA cases (PR 1.42) and two fetal deaths (PR 2.62) were observed. Regarding PE greater than 37 weeks, 24 SGA (PR 1.09) were born, and no fetal deaths were observed. Our findings were compared to previously published results.

Conclusions: PE was significantly associated with SGA newborns, especially premature PE. Prescribing aspirin for PE prophylaxis based only on clinical risk factors in a real-life scenario does not appear to be effective but resulted in a PE screening and prophylaxis protocol review and update at ME/UFRJ.

Keywords: Aspirin; Fetal death; Fetal growth restriction; Preeclampsia; Premature Infant.

MeSH terms

Aspirin / therapeutic use
Brazil
Female
Fetal Death / prevention & control
Fetal Growth Retardation / diagnosis
Fetal Growth Retardation / epidemiology
Fetal Growth Retardation / prevention & control
Gestational Age
Humans
Infant, Newborn
Infant, Small for Gestational Age
Pre-Eclampsia* / diagnosis
Pre-Eclampsia* / epidemiology
Pre-Eclampsia* / prevention & control
Pregnancy
Prevalence

Substances

Aspirin