{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:28:36Z","timestamp":1787099316311,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD076457"],"award-info":[{"award-number":["U10HD076457"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD043475"],"award-info":[{"award-number":["U10HD043475"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD078437"],"award-info":[{"award-number":["U10HD078437"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD076474"],"award-info":[{"award-number":["U10HD076474"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD078438"],"award-info":[{"award-number":["U10HD078438"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD078439"],"award-info":[{"award-number":["U10HD078439"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD076461"],"award-info":[{"award-number":["U10HD076461"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U01HD040636"],"award-info":[{"award-number":["U01HD040636"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate if the effect of low\u2010dose aspirin (LDA) commenced between 6 and 13\u2009weeks of gestational age (GA) on preterm delivery (PTD) is modified by total exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Post hoc analysis of a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Hospitals in low\u2010resource settings in Africa, Asia and Latin America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Outcomes were obtained for 11\u2009908\/11943 women at 6 0\/7 to 13 6\/7\u2009weeks' GA randomized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women received prepackaged two\u2010week medication allotments. Adherence was assessed by pill counts every 2\u2009weeks. Estimated relative risk and 95% confidence interval data for each outcome at each GA of treatment initiation weeks were obtained by fitting a Poisson model to each outcome, adjusting for site, treatment arm and GA at treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes Measures<\/jats:title>\n                    <jats:p>The primary outcome was PTD. Secondary outcomes included PTD &lt;\u200934\u2009weeks and perinatal mortality including analysis by region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median gestational age at treatment initiation was 10.1\u2009weeks (IQR 8.6, 12.0). 85.5% of the mothers had over 90% adherence to treatment. For each 1\u2009week increase of GA at treatment initiation, the treatment risk ratio did not change for PTD [RR 0.97 (95% CI, 0.93, 1.02)], PTD &lt;\u200934\u2009weeks [&lt;\u20090.98 (0.89, 1.07)] or perinatal mortality [1.04 (0.96, 1.12)], with no evidence of effect modification. For each 5% increase in adherence, the treatment risk ratio did not change for PTD [1.01 (0.99, 1.04)], PTD &lt;\u200934\u2009weeks [&lt;\u20090.99 (0.95, 1.03)] or perinatal mortality [1.02 (0.98, 1.06)], indicating no meaningful interaction with adherence. There was no effect modification by region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This analysis shows that the results of PTD, PTD\u2009&lt;\u200934\u2009weeks and perinatal mortality were not dependent on the timing of the initiation or adherence to treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/study\/NCT02409680\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT02409680\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70244","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:38:37Z","timestamp":1776645517000},"page":"1849-1856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Adherence Modify Low\u2010Dose Aspirin Effects in Pregnancy? Post Hoc Analysis From a Multi\u2010Centre Trial"],"prefix":"10.1111","volume":"133","author":[{"given":"Musaku","family":"Mwenechanya","sequence":"first","affiliation":[{"name":"University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail Mwapule","family":"Tembo","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":"Matthew K.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Christiana Care  Newark Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaprasad S.","family":"Goudar","sequence":"additional","affiliation":[{"name":"Jawaharlal Nehru Medical College KLE Academy of Higher Education and Research  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet L.","family":"Moore","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrityunjay C.","family":"Metgud","sequence":"additional","affiliation":[{"name":"Jawaharlal Nehru Medical College KLE Academy of Higher Education and Research  Belagavi Karnataka India"}],"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":"Jawaharlal Nehru Medical College KLE Academy of Higher Education and Research  Belagavi Karnataka 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