{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:28:26Z","timestamp":1787668106995,"version":"build-2736575974"},"reference-count":25,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241616-4\"><jats:title>Importance<\/jats:title><jats:p>It is unclear whether a higher dose (150-160 mg) or a lower dose (75 mg) of aspirin should be used to prevent preeclampsia.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-5\"><jats:title>Objectives<\/jats:title><jats:p>To compare the risk of preeclampsia and bleeding complications between women using 150 to 160 mg of aspirin and those using 75 mg of aspirin for preeclampsia prevention.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This nationwide cohort study included 13\u202f828 women giving birth at 22 weeks\u2019 gestation or later in Sweden between January 2017 and December 2020 who used low dose aspirin (75-160 mg) during pregnancy. Data were analyzed from October to November 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-7\"><jats:title>Exposure<\/jats:title><jats:p>The use of 150 to 160 mg or 75 mg of aspirin in pregnancy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-8\"><jats:title>Main Outcome and Measures<\/jats:title><jats:p>The main outcome was a preeclampsia diagnosis recorded in the maternal birth record at the time of hospital discharge. The main safety outcome was postpartum hemorrhage, defined as bleeding more than 1000 mL after delivery. Relative risks (RRs) and 95% CIs were estimated using a doubly robust inverse probability\u2013weighted regression adjustment model controlling for background characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-9\"><jats:title>Results<\/jats:title><jats:p>In the total cohort of 13\u202f828 women, the mean (SD) age was 33.0 (5.5) years and 3003 women (21.7%) were nulliparous. Of the women, 4687 (33.9%) were prescribed 150 to 160 mg of aspirin, and 9141 (66.1%) were prescribed 75 mg of aspirin. A total of 10\u202f635 women (76.9%) had at least 2 dispensed prescriptions of low-dose aspirin. Among women using 150 to 160 mg of aspirin, 443 (9.5%) developed preeclampsia compared with 812 (8.9%) of those using 75 mg of aspirin (adjusted RR [aRR], 1.07; 95% CI, 0.93-1.24). Additionally, the risk of postpartum hemorrhage between the groups was similar, with 326 women (6.9%) using 150 to 160 mg of aspirin experiencing a postpartum hemorrhage compared with 581 (6.4%) in the 75-mg group (aRR, 1.08; 95% CI, 0.90-1.30).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241616-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of 13\u202f828 women, no difference was found in preeclampsia incidence or bleeding complications between those using 150 to 160 mg of aspirin vs 75 mg of aspirin during pregnancy for preeclampsia prevention. These findings suggest that either dose may be a reasonable choice when using aspirin to prevent preeclampsia. However, large randomized trials investigating aspirin dose in pregnancy are still needed.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.57828","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T16:01:06Z","timestamp":1738598466000},"page":"e2457828","source":"Crossref","is-referenced-by-count":15,"title":["Prophylactic Aspirin Dose and Preeclampsia"],"prefix":"10.1001","volume":"8","author":[{"given":"Ellen","family":"Kupka","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Research and Higher Education, Center for Clinical Research, Dalarna, Uppsala University, Region Dalarna, Falun, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Hesselman","sequence":"additional","affiliation":[{"name":"Department of Research and Higher Education, Center for Clinical Research, Dalarna, Uppsala University, Region Dalarna, Falun, Sweden"},{"name":"Department of Women\u2019s and Children\u2019s health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3hanna","family":"Gunnarsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s health, Uppsala University, Uppsala, Sweden"},{"name":"Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"},{"name":"Department of Obstetrics and Gynecology, Landsp\u00edtali The National University Hospital of Iceland, Reykjav\u00edk, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Karin","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cluver","sequence":"additional","affiliation":[{"name":"Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Tong","sequence":"additional","affiliation":[{"name":"Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne","family":"Hastie","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s health, Uppsala University, Uppsala, Sweden"},{"name":"Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Women\u2019s and Children\u2019s health, Uppsala University, Uppsala, Sweden"},{"name":"Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"zoi241616r1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.preghy.2021.09.008","article-title":"The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis and management recommendations for international practice.","volume":"27","author":"Magee","year":"2022","journal-title":"Pregnancy Hypertens"},{"issue":"10297","key":"zoi241616r2","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/S0140-6736(20)32335-7","article-title":"Pre-eclampsia.","volume":"398","author":"Chappell","year":"2021","journal-title":"Lancet"},{"issue":"6","key":"zoi241616r3","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: a WHO systematic analysis.","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"12","key":"zoi241616r4","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1001\/jama.2021.14781","article-title":"Aspirin use to prevent preeclampsia and related morbidity and mortality: US preventive services task force recommendation statement.","volume":"326","author":"Davidson","year":"2021","journal-title":"JAMA"},{"issue":"Suppl 1","key":"zoi241616r6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ijgo.12802","article-title":"The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention.","volume":"145","author":"Poon","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"issue":"2","key":"zoi241616r7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.ajog.2016.10.016","article-title":"Antiplatelet therapy before or after 16 weeks\u2019 gestation for preventing preeclampsia: an individual participant data meta-analysis.","volume":"216","author":"Meher","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"zoi241616r8","doi-asserted-by":"publisher","first-page":"95.e1","DOI":"10.1016\/j.ajog.2020.07.023","article-title":"Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study.","volume":"224","author":"Hastie","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"zoi241616r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.100878","article-title":"Low-dose asprin use during pregnancy may be a potential risk for postpartum hemorrhage and increased blood loss: a systematic review and meta-analysis.","volume":"5","author":"Jiang","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"8","key":"zoi241616r10","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"issue":"11","key":"zoi241616r11","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s10654-009-9350-y","article-title":"The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research.","volume":"24","author":"Ludvigsson","year":"2009","journal-title":"Eur J Epidemiol"},{"issue":"7","key":"zoi241616r13","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1002\/pds.1294","article-title":"The new Swedish prescribed drug register\u2013opportunities for pharmacoepidemiological research and experience from the first six months.","volume":"16","author":"Wettermark","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"2","key":"zoi241616r15","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10654-016-0117-y","article-title":"Registers of the Swedish total population and their use in medical research.","volume":"31","author":"Ludvigsson","year":"2016","journal-title":"Eur J Epidemiol"},{"issue":"7","key":"zoi241616r16","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1056\/NEJMoa1704559","article-title":"Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia.","volume":"377","author":"Rolnik","year":"2017","journal-title":"N Engl J Med"},{"issue":"7","key":"zoi241616r17","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1111\/j.1651-2227.1996.tb14164.x","article-title":"Intrauterine growth curves based on ultrasonically estimated foetal weights.","volume":"85","author":"Mars\u00e1l","year":"1996","journal-title":"Acta Paediatr"},{"issue":"10","key":"zoi241616r20","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004659.pub3","article-title":"Antiplatelet agents for preventing pre-eclampsia and its complications.","volume":"2019","author":"Duley","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"zoi241616r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101000","article-title":"Comparing aspirin 75-81 mg vs 150-162 mg for prevention of preterm preeclampsia: systematic review and meta-analysis.","volume":"5","author":"Ghesquiere","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"10","key":"zoi241616r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101098","article-title":"Comparing aspirin 75 to 81 mg vs 150 to 162 mg for prevention of preterm preeclampsia: systematic review and meta-analysis: questionable quality and small study effects","volume":"5","author":"Cluver","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"2","key":"zoi241616r25","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1111\/aogs.13994","article-title":"Accuracy of postpartum hemorrhage coding in the Swedish Pregnancy Register.","volume":"100","author":"Ladfors","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"zoi241616r5","unstructured":"National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Accessed May 2, 2021. https:\/\/www.nice.org.uk\/guidance\/ng133"},{"key":"zoi241616r12","unstructured":"K\u00e4ll\u00e9n? B, K\u00e4ll\u00e9n? K. The Swedish medical birth register\u2014a summary of content and quality. 2003. Accessed January 11, 2022. https:\/\/lup.lub.lu.se\/record\/1127699"},{"key":"zoi241616r14","unstructured":"Socialstyrelsen. National Patient Register. 2022. Accessed September 1, 2023. https:\/\/www.socialstyrelsen.se\/en\/statistics-and-data\/registers\/national-patient-register\/"},{"key":"zoi241616r18","unstructured":"SFOG. Riktlinjer F\u00f6r Hypertonisjukdomar under Graviditet. 2019. Accessed December 21, 2024. https:\/\/www.sfog.se\/media\/337263\/hypertonisjukdomar-under-graviditet-sfog-2019-10-23-reviderad-210121.pdf"},{"key":"zoi241616r19","unstructured":"The Fetal Medicine Foundation. Risk for Preeclampsia. Accessed September 7, 2023. https:\/\/fetalmedicine.org\/research\/assess\/preeclampsia\/first-trimester"},{"key":"zoi241616r23","unstructured":"Pan African Clinical Trials Registry. The PEARLS trial. Accessed May 20, 2024. https:\/\/pactr.samrc.ac.za\/TrialDisplay.aspx?TrialID=27291"},{"key":"zoi241616r24","unstructured":"The Ohio State University. Ohio State to receive $14 million to study optimal aspirin therapy in pregnancy. 2023. Accessed February 2, 2024. https:\/\/wexnermedical.osu.edu\/mediaroom\/pressreleaselisting\/pcori-award-to-study-optimal-aspirin-therapy-in-pregnancy"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2829827\/kupka_2025_oi_241616_1738185891.57767.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T16:01:10Z","timestamp":1738598470000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2829827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.57828","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]}}}