2026-04-13T05:58:05Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4825502025-10-27T12:44:14Zcom_2072_98col_2072_378192

Placental growth factor at 24-28 weeks for aspirin discontinuation in pregnancies at high risk for preterm preeclampsia : Post hoc analysis of trial Ricart, Marta Bonacina, Erika Garcia-Manau, Pablo López, Monica Caamiña Álvarez, Sara Vives, Àngels Lopez-Quesada, Eva Maroto, Anna de Mingo, Laura Pintado, Elena Ferrer Costa, Roser Martin Gonzalez, Lourdes Rodriguez-Zurita, Alicia Garcia Cancela, Esperanza Pallarols Badia, Mar Pratcorona, Laia Teixidor, Mireia Orizales Lago, Carmen María Ocaña, Vanesa del Barco, Ester Carreras Moratonas, Elena Suy, Anna Mendoza, Manel Aspirin PlGF Preeclampsia Salicylic acid Screening preeclampsia Altres ajuts: acords transformatius de la UAB This study aims to evaluate the safety of discontinuing aspirin treatment at 24-28 weeks in women at high risk after first-trimester combined screening for preeclampsia (PE) and normal placental growth factor (PlGF) levels at 24-28 weeks of gestation. This is a post hoc analysis of the StopPRE trial, conducted at nine Spanish maternity hospitals from September 2019 to September 2021. In the StopPRE trial, all high-risk single pregnancies identified during first-trimester screening for PE were treated with 150 mg of daily aspirin. Out of 1604 eligible women with a soluble fms-like tyrosine kinase-1 to PlGF ratio (sFlt-1/PlGF) ≤38 at 24-28 weeks, 968 were randomly assigned in a 1:1 ratio to either continue aspirin until 36 weeks (control group) or discontinue it (intervention group). In this secondary analysis, only women with PlGF ≥100 pg/mL at 24-28 weeks were included. As in the StopPRE trial, the non-inferiority margin was set at a 1.9% difference in preterm PE incidence between the groups. Among the 13 983 screened pregnant women, 1984 (14.2%) were deemed high-risk for preterm PE, of which 397 (20.0%) were ineligible, 636 declined participation, and 32 were excluded. Ultimately, 919 women with PlGF >100 pg/mL were randomized and included in this analysis. Preterm PE occurred in 0.9% of the intervention group (4 out of 465) and 1.5% of the control group (7 out of 454), indicating non-inferiority of aspirin discontinuation. There were no significant differences between the groups in adverse pregnancy outcomes before 37 weeks, at <34 weeks, or ≥37 weeks. Minor antepartum hemorrhage incidence was significantly lower in the intervention group (absolute difference, −5.96; 95% CI, −10.10 to −1.82). Discontinuation of aspirin treatment at 24-28 weeks in women with PlGF levels ≥100 pg/mL was non-inferior to continuing until 36 weeks for preventing preterm PE. However, these findings should be interpreted with caution, as they originate from a subanalysis of the StopPRE trial. 2024 Article Instituto de Salud Carlos III PI17/01944 Acta obstetricia et gynecologica Scandinavica ; Vol. 103, Num. 11 (November 2024), p. 2273-2280 open access Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. https://creativecommons.org/licenses/by-nc/4.0/