{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:08:50Z","timestamp":1775902130451,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["TL1 TR002555"],"award-info":[{"award-number":["TL1 TR002555"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003The primary aim of this study was to examine the United States Preventative Services Task Force (USPSTF) guidelines concordant low-dose aspirin (LDA) counseling and factors associated with counseling in nulliparous birthing individuals.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a retrospective cohort study of nulliparous birthing individuals who delivered between January 1, 2019 and June 30, 2020 and received prenatal care at the Duke High Risk Obstetrical Clinics (HROB). All nulliparous patients over 18 years old who established or transferred care to HROB by 16 weeks, 6 days were included in the analysis. We excluded patients with more than two previous first-trimester pregnancy losses, multiple gestation, a known contraindication to LDA, initiation of LDA prior to their prenatal care, or documented medical history of coagulation disorder. Bivariate associations between demographic\/medical characteristics and our primary outcome, receipt of counseling (yes\/no), were assessed using two-sample t-tests for continuous variables and chi-square or Fisher's exact test for categorical variables. Factors significantly associated with the primary outcome (p\u2009&lt;\u20090.05) were entered into the multivariable logistic regression model.<\/jats:p><jats:p>\n            Results\u2003Among 391 birthing individuals included in the final analysis cohort, 51.7% of eligible patients received guideline consistent LDA counseling. Factors associated with increased odds of LDA counseling were advanced maternal age (adjusted odds ratio [aOR]: 1.05, 95% confidence interval [CI]: 1.01\u20131.09), Black race compared with White race (aOR:1.75, 95% CI: 1.03\u20132.98), chronic hypertension (aOR: 4.17, 95% CI: 1.82\u20139.55), and obesity (aOR: 5.02, 95% CI: 3.12\u20138.08).<\/jats:p><jats:p>\n            Conclusion\u2003Approximately half of all nulliparous birthing individuals had appropriately documented LDA counseling. The USPSTF guidelines on LDA for preeclampsia risk reduction are complex, which may lead to ineffective provider adherence. Efforts to simplify guidelines and improve LDA counseling are vital to ensuring this low-cost, evidence-based preeclampsia prevention is used in a consistent and equitable manner.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2096-3466","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T22:50:05Z","timestamp":1684536605000},"page":"e2004-e2009","source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Factors Associated with Guideline Concordant Clinician Counseling about Low-Dose Aspirin to Prevent Preeclampsia in Nulliparous Patients"],"prefix":"10.1055","volume":"41","author":[{"given":"Sabrena O.","family":"Myers","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shauntell","family":"Luke","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaila L.","family":"Ramey-Collier","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Truong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geeta K.","family":"Swamy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8384-3721","authenticated-orcid":false,"given":"Sarahn M.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.nwh.2017.12.002","article-title":"Low-dose aspirin for the prevention of preeclampsia","volume":"22","author":"H C Fantasia","year":"2018","journal-title":"Nurs Womens Health"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1001\/jama.2021.8551","article-title":"Aspirin use to prevent preeclampsia and related morbidity and mortality: updated evidence report and systematic review for the US Preventive Services Task Force","volume":"326","author":"J T Henderson","year":"2021","journal-title":"JAMA"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S0002-9378(98)70254-6","article-title":"Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis","volume":"179","author":"G P Sacks","year":"1998","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1111\/j.1600-0897.2010.00831.x","article-title":"Immunology of pre-eclampsia","volume":"63","author":"C W Redman","year":"2010","journal-title":"Am J Reprod Immunol"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","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":"K W Davidson","year":"2021","journal-title":"JAMA"},{"key":"ref6","volume-title":"Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality","author":"J T Henderson","year":"2021"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"819","DOI":"10.7326\/M14-1884","article-title":"Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement","volume":"161","author":"M L LeFevre","year":"2014","journal-title":"Ann Intern Med"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s12884-017-1312-x","article-title":"A description of the methods of the aspirin supplementation for pregnancy indicated risk reduction in nulliparas (ASPIRIN) study","volume":"17","author":"M K Hoffman","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S0140-6736(19)32973-3","article-title":"Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial","volume":"395","author":"M K Hoffman","year":"2020","journal-title":"Lancet"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/AOG.0000000000002708","article-title":"ACOG Committee Opinion No. 743: low-dose aspirin use during pregnancy","volume":"132","author":"ACOG Committee Opinion No","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"e2130804","DOI":"10.1001\/jamanetworkopen.2021.30804","article-title":"Use of a smartphone app to explore potential underuse of prophylactic aspirin for preeclampsia","volume":"04","author":"T Krishnamurti","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"e2142343","DOI":"10.1001\/jamanetworkopen.2021.42343","article-title":"Estimated prevalence of risk factors for 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meta-analysis","volume":"31","author":"S Roberge","year":"2012","journal-title":"Fetal Diagn Ther"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2096-3466.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:32:55Z","timestamp":1730813575000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2096-3466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,19]]},"references-count":18,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2096-3466","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,19]]},"published":{"date-parts":[[2023,5,19]]}}}