{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:47:02Z","timestamp":1777870022594,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study evaluates the association of low\u2010dose aspirin (LDA) with hemoglobin (Hb) levels during pregnancy and explores how changes in Hb levels relate to hypertensive disorders of pregnancy (HDP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis of a randomized controlled trial comprised 249 pregnant women recruited from a regional hospital in Durban, South Africa (SA). Participants were randomized to receive either 162\u2009mg of LDA daily (intervention) or standard care (control). Hemoglobin levels were measured at enrolment and again at birth. Data on maternal outcomes, including HDP, were analyzed in relation to changes in Hb levels to assess potential associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At enrolment, the predominant Hb range was 9.0\u201310.9\u2009g\/dL (mild anemia) in 51.4% of participants, with comparable Hb distributions between groups. By birth, 43.4% remained mildly anemic, while 44.2% had normal Hb levels (11\u201313\u2009g\/dL). Among participants who experienced a decline in Hb, the reduction was significantly mitigated in the intervention compared to the control group (\u0394Hb\u2009=\u2009\u22120.902 vs. \u22121.422,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.088). Declining Hb levels increase the odds of developing HDP compared to increasing Hb (odds ratio\u2009=\u20092.29 vs. 0.44,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032). However, the intervention group within this subgroup had 76% reduction in risk of developing HDP (RR\u2009=\u20090.24, 95% confidence interval [0.11\u20130.53],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low\u2010dose aspirin was associated with a smaller decline in Hb levels and lower HDP risk; consistent with a potential hematological benefit beyond preeclampsia prevention, although this represents an association rather than causation. Hemoglobin reduction might also serve as an early predictor of HDP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70710","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T10:52:18Z","timestamp":1764586338000},"page":"982-988","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of low\u2010dose aspirin on hemoglobin levels in pregnancy: A secondary analysis of a randomized controlled trial for prevention of hypertensive disorders of pregnancy"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2079-7630","authenticated-orcid":false,"given":"N. M.","family":"Ngcobo","sequence":"first","affiliation":[{"name":"School of Laboratory Medicine and Medical Sciences, College of Health Sciences University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Dorsamy","sequence":"additional","affiliation":[{"name":"School of Laboratory Medicine and Medical Sciences, College of Health Sciences University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Bagwandeen","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, School of Nursing and Public Health University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Z.","family":"Mkhize","sequence":"additional","affiliation":[{"name":"Women's Health and HIV Research Group, Department of Obstetrics and Gynaecology University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Moodley","sequence":"additional","affiliation":[{"name":"Women's Health and HIV Research Group, Department of Obstetrics and Gynaecology University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.14781"},{"key":"e_1_2_11_3_1","volume-title":"Anaemia [Internet]","author":"World Health Organization","year":"2023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S406196"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/frhem.2024.1457158"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343123"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01874-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2383-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.115.05934"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-06606-0"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.59215\/prn.24.0321011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25105150"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms242316749"},{"key":"e_1_2_11_14_1","volume-title":"Hypertensive disorders in pregnancy: 2019 national guideline","author":"Moodley J","year":"2019"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4102\/safp.v63i1.5236"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1349746"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.03.044"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.21793"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10803"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16676"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22136985"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871530323666221103105349"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-06-027631"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20184370"},{"issue":"1","key":"e_1_2_11_25_1","first-page":"1","article-title":"Hemoglobin evaluation in hypertensive disorders of pregnancy","volume":"15","author":"Sattar R","year":"2021","journal-title":"J Dow Univ Health Sci"},{"issue":"12","key":"e_1_2_11_26_1","first-page":"68","article-title":"Association of gestational anemia with pregnancy\u2010induced hypertension in a private hospital maternity care: gestational anemia with pregnancy\u2010induced hypertension","volume":"4","author":"Zafar K","year":"2023","journal-title":"Pak J Health Sci"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.06.001"},{"issue":"1","key":"e_1_2_11_28_1","article-title":"Anaemia at mid\u2010pregnancy is associated with prehypertension in late pregnancy among urban women","volume":"29","author":"Goodchild C","year":"2024","journal-title":"Health SA"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.313276"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.07.038"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.561"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14093"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70710","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:12:40Z","timestamp":1777561960000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ijgo.70710"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70710","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}