{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:09:43Z","timestamp":1787850583220,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Two\u2010hundred pregnancies involving 100 women with essential thrombocythemia (ET) were accessed from Mayo Clinic databases (1990\u20132023). Median platelet count displayed a decline during pregnancy, nadiring at 48% of baseline, in the third trimester: 704\u2013369\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. Live birth rate was 72%. Of 53 (27%) unintentional pregnancy losses, 48 (24%) occurred in the first trimester. Other fetal complications included preterm birth 3%, intrauterine growth retardation 3%, and stillbirth 1%. Maternal complications included major hemorrhage (7%), preeclampsia (6%), thrombosis (1%), and placental abruption (0.5%). Antepartum management included no specific therapy in 52 (26%), aspirin alone in 112 (56%), aspirin combined with cytoreductive drugs or systemic anticoagulants in 23 (12%), and other permutations in the remaining. Postpartum systemic anticoagulation was documented in 29 (15%) pregnancies. Unintentional first\u2010trimester loss was predicted by prior fetal loss (43% vs. 18%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), diabetes mellitus (DM; 67% vs. 23%; <jats:italic>p<\/jats:italic>\u2009=\u2009.02), and absence of aspirin therapy (45% vs. 14%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01); the salutary effect of aspirin therapy was independent of the other two risk factors and apparent in both high (presence of \u22651 risk factor; 33% vs. 61%; <jats:italic>p<\/jats:italic>\u2009=\u2009.07) and low (absence of both risk factors; 10% vs. 34%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) risk scenarios. The benefit of aspirin therapy, in preventing first\u2010trimester loss, was significant in both <jats:italic>JAK2<\/jats:italic>\u2010mutated (18% vs. 50%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) and <jats:italic>CALR<\/jats:italic>\u2010mutated (8% vs. 43%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) cases. Aspirin use was also associated with a lower risk of venous thrombosis (0% vs. 3%; <jats:italic>p<\/jats:italic>\u2009=\u2009.03). By contrast, the use of systemic anticoagulation, antepartum or postpartum, did not influence fetal or maternal complication rates. <jats:italic>CALR<\/jats:italic> mutation and DM predicted maternal hemorrhage (13% vs. 4%; <jats:italic>p<\/jats:italic>\u2009=\u2009.05) and preeclampsia (33% vs. 5%; <jats:italic>p<\/jats:italic>\u2009=\u2009.03), respectively. The current study demonstrates the protective role of aspirin in preventing first\u2010trimester loss in ET, independent of driver mutation status or other risk factors.<\/jats:p>","DOI":"10.1002\/ajh.27416","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T02:48:18Z","timestamp":1718246898000},"page":"1862-1869","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Aspirin therapy is associated with a lower risk of pregnancy loss in both <scp><i>JAK2\u2010<\/i><\/scp> and <scp><i>CALR\u2010<\/i><\/scp>mutated essential thrombocythemia\u2014A Mayo Clinic study of 200 pregnancies"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-6172","authenticated-orcid":false,"given":"Naseema","family":"Gangat","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota 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