{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:05:10Z","timestamp":1792699510407,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the impact of low\u2010dose aspirin (LDA) starting in early pregnancy on delaying preterm hypertensive disorders of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Non\u2010prespecified secondary analysis of a randomised masked trial of LDA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR) clusters, a prospective, population\u2010based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Pakistan, India (two sites\u2010Belagavi and Nagpur) and Guatemala.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      Nulliparous singleton pregnancies between 6\n                      <jats:sup>+0<\/jats:sup>\n                      weeks and 13\n                      <jats:sup>+6<\/jats:sup>\n                      \u2009weeks in six low\u2010middle income countries (Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, Zambia) enrolled in the ASPIRIN Trial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared the incidence of HDP at delivery at three gestational age periods (&lt;28, &lt;34 and &lt;37\u2009weeks) between women who were randomised to aspirin or placebo. Women were included if they were randomised and had an outcome at or beyond 20\u2009weeks (Modified Intent to Treat).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Our primary outcome was pregnancies with HDP associated with preterm delivery (HDP@delivery) before &lt;28, &lt;34 and &lt;37\u2009weeks. Secondary outcomes included small for gestational age (SGA) &lt;10th percentile, &lt;5th percentile, and perinatal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 11\u2009976 pregnancies, LDA did not significantly lower HDP@delivery &lt;28\u2009weeks (relative risk [RR] 0.18, 95% confidence interval [CI] 0.02\u20131.52); however, it did lower HDP@delivery &lt;34\u2009weeks (RR 0.37, 95% CI 0.17\u20130.81) and HDP@delivery &lt;37\u2009weeks (RR 0.66, 95% CI 0.49\u20130.90). The overall rate of HDP did not differ between the two groups (RR\u20091.08, 95% CI 0.94\u20131.25). Among those pregnancies who had HDP, SGA &lt;10th percentile was reduced (RR 0.81, 95% CI 0.67\u20130.99), though SGA &lt;5th percentile was not (RR 0.84, 95%\u2009CI 0.64\u20131.09). Similarly, perinatal mortality among pregnancies with HDP occurred less frequently (RR 0.55, 95% CI 0.33\u20130.92) in those receiving LDA. Pregnancies randomised to LDA delivered later with HDP compared with those receiving placebo (median gestational age 38.5\u2009weeks vs. 37.9\u2009weeks;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this secondary analysis of a study of low\u2010risk nulliparous singleton pregnancies, early administration of LDA resulted in lower rates of preterm HDP and delivery before 34 and 37\u2009weeks but not in the overall rate of HDP. These results suggest that LDA works in part by delaying HDP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17607","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T03:55:08Z","timestamp":1689825308000},"page":"16-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Aspirin delays the onset of hypertensive disorders of pregnancy among nulliparous pregnant women: A secondary analysis of the\n                    <scp>ASPIRIN<\/scp>\n                    trial"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2176-4697","authenticated-orcid":false,"given":"Avinash","family":"Kavi","sequence":"first","affiliation":[{"name":"KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College  Belagavi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-8693","authenticated-orcid":false,"given":"Matthew K.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Christiana Care Health Services  Newark Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8871-5072","authenticated-orcid":false,"given":"Manjunath S.","family":"Somannavar","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College  Belagavi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0844-8569","authenticated-orcid":false,"given":"Mrityunjay\u00a0C.","family":"Metgud","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College  Belagavi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-7053","authenticated-orcid":false,"given":"Shivaprasad S.","family":"Goudar","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College  Belagavi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Moore","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Nielsen","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Goco","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-5444","authenticated-orcid":false,"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Lokangaka","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health  Kinshasa Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette","family":"Tshefu","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health  Kinshasa Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Bauserman","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musaku","family":"Mwenechanya","sequence":"additional","affiliation":[{"name":"University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elwyn","family":"Chomba","sequence":"additional","affiliation":[{"name":"University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar A.","family":"Carlo","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n de Centroam\u00e9rica y Panam\u00e1  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy F.","family":"Krebs","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleem","family":"Jessani","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert\u00a0L.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabirkumar","family":"Das","sequence":"additional","affiliation":[{"name":"Lata Medical Research Foundation  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-7421","authenticated-orcid":false,"given":"Archana","family":"Patel","sequence":"additional","affiliation":[{"name":"Lata Medical Research Foundation  Nagpur India"},{"name":"Datta Meghe Institute of Medical Sciences  Sawangi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia L.","family":"Hibberd","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Esamai","sequence":"additional","affiliation":[{"name":"Department of Child Health and Paediatrics Moi University School of Medicine  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherri","family":"Bucher","sequence":"additional","affiliation":[{"name":"School of Medicine Indiana University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Koso\u2010Thomas","sequence":"additional","affiliation":[{"name":"<i>Eunice Kennedy Shriver<\/i> National Institute of Child Health and Human Development  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Silver","sequence":"additional","affiliation":[{"name":"University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard\u00a0J.","family":"Derman","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.04.032"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706475"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.003497"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60712-0"},{"key":"e_1_2_12_7_1","volume-title":"WHO recommendations for prevention and treatment of pre\u2010eclampsia and eclampsia","author":"World Health Organization","year":"2011"},{"key":"e_1_2_12_8_1","volume-title":"Hypertension in pregnancy","author":"American College of Obstetricians and Gynecologists","year":"2013"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002709"},{"key":"e_1_2_12_10_1","volume-title":"Hypertension in pregnancy: quality standard","author":"National Institute for Health and Care Excellence","year":"2013"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12802"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.203"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.034"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1312-x"},{"key":"e_1_2_12_16_1","volume-title":"Low\u2010dose aspirin for the prevention of morbidity and mortality from pre\u2010eclampsia. A systematic evidence review for the US Preventive Services Task Force. Evidence syntheses, no. 112","author":"Henderson J","year":"2014"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.074294"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32973-3"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/10641950109152635"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.04.022"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-020-01020-8"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803123381101"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92633-6"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2021.100003"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12421"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022056"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.t01-1-02097.x"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T20:45:21Z","timestamp":1708548321000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.17607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":26,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/1471-0528.17607"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.17607","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,20]]},"assertion":[{"value":"2023-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}