{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:22Z","timestamp":1747196122982,"version":"3.40.5"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the implementation of low-dose aspirin in pregnancy for the prevention of utero-placental complications among gynecologists in the Netherlands between 2016 and 2021. In this timeframe, a national guideline about aspirin in pregnancy was introduced by the Dutch Society of Obstetrics and Gynecology.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>A national online survey among Dutch gynecologists and residents was performed. An online questionnaire was distributed among the members of the Dutch Society of Obstetrics and Gynecology in April 2016 and April 2021. Main outcome measure was the proportion of gynecologists indicating prescription of aspirin in pregnancy for high and moderate risk indications.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>In 2016, 133 respondents completed the survey, and in 2021 231. For all indications mentioned in the guideline there was an increase in prescribing aspirin in 2021 in comparison to 2016. More specifically, the percentage of gynecologists prescribing aspirin for a history of preeclampsia before 34 weeks, between 34 and 37 weeks and at term increased from respectively 94% to 100%, 39% to 98%, and 15% to 97%. Consultant obstetricians and respondents working in an university hospital did not more often indicate the prescription of aspirin for tertiary care indications in 2021. Future use of a prediction model was suggested in the narrative comments.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>Implementation of aspirin in pregnancy among Dutch gynecologists substantially improved after a five year timeframe in which the national guideline on aspirin during pregnancy was introduced and trials confirming the effect of aspirin were published.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0268673","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T17:32:55Z","timestamp":1654795975000},"page":"e0268673","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Improved implementation of aspirin in pregnancy among Dutch gynecologists: Surveys in 2016 and 2021"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-8825","authenticated-orcid":true,"given":"Jeske Milou","family":"bij de Weg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Visser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn Alexander","family":"Oudijk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna Inge Petra","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christianne Johanna Maria","family":"de Groot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjon Alina","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"issue":"7","key":"pone.0268673.ref001","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1002\/pd.4403","article-title":"Low-dose aspirin for prevention of adverse outcomes related to abnormal placentation","volume":"34","author":"E Bujold","year":"2014","journal-title":"Prenatal diagnosis"},{"issue":"8898","key":"pone.0268673.ref002","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S0140-6736(94)92633-6","article-title":"CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group.","volume":"343","year":"1994","journal-title":"Lancet (London, England)."},{"issue":"9575","key":"pone.0268673.ref003","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1016\/S0140-6736(07)60712-0","article-title":"Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data","volume":"369","author":"LM Askie","year":"2007","journal-title":"Lancet (London, England)."},{"issue":"1\u20132","key":"pone.0268673.ref004","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3109\/07420528.2012.717455","article-title":"Chronotherapy with low-dose aspirin for prevention of complications in pregnancy","volume":"30","author":"DE Ayala","year":"2013","journal-title":"Chronobiology international"},{"issue":"8433","key":"pone.0268673.ref005","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/S0140-6736(85)92207-X","article-title":"Prevention of pre-eclampsia by early antiplatelet therapy","volume":"1","author":"M Beaufils","year":"1985","journal-title":"Lancet (London, England)."},{"issue":"11","key":"pone.0268673.ref006","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1056\/NEJM199803123381101","article-title":"Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units","volume":"338","author":"S Caritis","year":"1998","journal-title":"The New England journal of medicine"},{"issue":"5","key":"pone.0268673.ref007","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1002\/uog.12421","article-title":"Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis.","volume":"41","author":"S Roberge","year":"2013","journal-title":"Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology"},{"issue":"8755","key":"pone.0268673.ref008","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1016\/0140-6736(91)93124-R","article-title":"Prevention of fetal growth retardation with low-dose aspirin: findings of the EPREDA trial","volume":"337","author":"S Uzan","year":"1991","journal-title":"Lancet (London, England)."},{"issue":"2","key":"pone.0268673.ref009","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/AOG.0b013e3181e9322a","article-title":"Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis","volume":"116","author":"E Bujold","year":"2010","journal-title":"Obstetrics and gynecology."},{"volume-title":"Clinical Practice Guidelines We Can Trust","year":"2011","author":"Medicine Io","key":"pone.0268673.ref010"},{"issue":"1","key":"pone.0268673.ref011","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","year":"2018","journal-title":"Obstetrics and gynecology"},{"journal-title":"Guideline: Hypertension in Pregnancy","year":"2019","author":"NICE","key":"pone.0268673.ref012"},{"issue":"11","key":"pone.0268673.ref013","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":"ML LeFevre","year":"2014","journal-title":"Annals of internal medicine"},{"issue":"5","key":"pone.0268673.ref014","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/ajo.12399","article-title":"SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014","volume":"55","author":"SA Lowe","year":"2015","journal-title":"The Australian & New Zealand journal of obstetrics & gynaecology"},{"journal-title":"NVOG richtlijn: Hypertensieve aandoeningen in de zwangerschap","year":"2018","author":"NVOG","key":"pone.0268673.ref015"},{"journal-title":"NVOG Module: Acetylsalicylzuur","year":"2019","author":"NVOG","key":"pone.0268673.ref016"},{"key":"pone.0268673.ref017","first-page":"g3725","article-title":"Evidence based medicine: a movement in crisis","volume":"348","author":"T Greenhalgh","year":"2014","journal-title":"BMJ (Clinical research ed)."},{"issue":"23","key":"pone.0268673.ref018","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1001\/jama.2013.281334","article-title":"Enhancing physicians\u2019 use of clinical guidelines","volume":"310","author":"PJ Pronovost","year":"2013","journal-title":"Jama"},{"issue":"1032","key":"pone.0268673.ref019","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1136\/pgmj.2010.116012","article-title":"Patterns of \u2019leakage\u2019 in the utilisation of clinical guidelines: a systematic review.","volume":"87","author":"S Mickan","year":"2011","journal-title":"Postgraduate medical journal"},{"issue":"10","key":"pone.0268673.ref020","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD004659.pub3","article-title":"Antiplatelet agents for preventing pre-eclampsia and its complications","volume":"2019","author":"L Duley","year":"2019","journal-title":"The Cochrane database of systematic reviews."},{"issue":"5","key":"pone.0268673.ref021","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/pd.5645","article-title":"Aspirin for prevention of preeclampsia and fetal growth restriction","volume":"40","author":"L Loussert","year":"2020","journal-title":"Prenatal diagnosis"},{"issue":"5","key":"pone.0268673.ref022","doi-asserted-by":"crossref","first-page":"585.e1","DOI":"10.1016\/j.ajog.2017.07.038","article-title":"Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history.","volume":"217","author":"LC Poon","year":"2017","journal-title":"American journal of obstetrics and gynecology"},{"issue":"3","key":"pone.0268673.ref023","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ajog.2017.11.561","article-title":"Aspirin for the prevention of preterm and term preeclampsia: systematic review and metaanalysis.","volume":"218","author":"S Roberge","year":"2018","journal-title":"American journal of obstetrics and gynecology"},{"issue":"2","key":"pone.0268673.ref024","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ajog.2016.09.076","article-title":"The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis.","volume":"216","author":"S Roberge","year":"2017","journal-title":"American journal of obstetrics and gynecology"},{"key":"pone.0268673.ref025","article-title":"Prevention of preeclampsia with aspirin","author":"DL Rolnik","year":"2020","journal-title":"American journal of obstetrics and gynecology"},{"issue":"7","key":"pone.0268673.ref026","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1056\/NEJMoa1704559","article-title":"Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia","volume":"377","author":"DL Rolnik","year":"2017","journal-title":"The New England journal of medicine"},{"key":"pone.0268673.ref027","unstructured":"Castor Electronic Data Capture 2019 [27 Aug. 2019]. Available from: https:\/\/castoredc.com."},{"issue":"2","key":"pone.0268673.ref028","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/aogs.13066","article-title":"Risk factors for recurrence of hypertensive disorders of pregnancy, a population-based cohort study","volume":"96","author":"C Ebbing","year":"2017","journal-title":"Acta obstetricia et gynecologica Scandinavica"},{"issue":"1","key":"pone.0268673.ref029","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/S0002-9378(12)90917-5","article-title":"Low-dose aspirin in the prevention of preeclampsia and fetal growth retardation: rationale, mechanisms, and clinical trials","volume":"168","author":"GA Dekker","year":"1993","journal-title":"American journal of obstetrics and gynecology"},{"issue":"2","key":"pone.0268673.ref030","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/00001703-199504000-00011","article-title":"Low-dose aspirin therapy in obstetrics","volume":"7","author":"HC Wallenburg","year":"1995","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"7076","key":"pone.0268673.ref031","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1136\/bmj.314.7076.253","article-title":"Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies).","volume":"314","author":"R Rai","year":"1997","journal-title":"BMJ (Clinical research ed)."},{"key":"pone.0268673.ref032","first-page":"i1753","article-title":"Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies","volume":"353","author":"E Bartsch","year":"2016","journal-title":"BMJ (Clinical research ed)."},{"issue":"1","key":"pone.0268673.ref033","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000341264","article-title":"Competing risks model in early screening for preeclampsia by biophysical and biochemical markers","volume":"33","author":"R Akolekar","year":"2013","journal-title":"Fetal Diagn Ther"},{"issue":"4","key":"pone.0268673.ref034","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/uog.18816","article-title":"ASPRE trial: performance of screening for preterm pre-eclampsia.","volume":"50","author":"DL Rolnik","year":"2017","journal-title":"Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology"},{"issue":"7","key":"pone.0268673.ref035","doi-asserted-by":"crossref","first-page":"Cd004734","DOI":"10.1002\/14651858.CD004734.pub4","article-title":"Aspirin and\/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia","volume":"2014","author":"PG de Jong","year":"2014","journal-title":"The Cochrane database of systematic reviews"},{"issue":"6","key":"pone.0268673.ref036","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1093\/humrep\/det022","article-title":"Preconceptional low-dose aspirin for the prevention of hypertensive pregnancy complications and preterm delivery after IVF: a meta-analysis with individual patient data","volume":"28","author":"E Groeneveld","year":"2013","journal-title":"Hum Reprod"},{"issue":"17","key":"pone.0268673.ref037","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1056\/NEJMoa1000641","article-title":"Aspirin plus heparin or aspirin alone in women with recurrent miscarriage","volume":"362","author":"SP Kaandorp","year":"2010","journal-title":"The New England journal of medicine"},{"issue":"9937","key":"pone.0268673.ref038","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0140-6736(14)60157-4","article-title":"Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial","volume":"384","author":"EF Schisterman","year":"2014","journal-title":"Lancet (London, England)."},{"issue":"4","key":"pone.0268673.ref039","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1097\/AOG.0000000000000736","article-title":"Low-dose aspirin and preterm birth: a randomized controlled trial.","volume":"125","author":"RM Silver","year":"2015","journal-title":"Obstetrics and gynecology"},{"key":"pone.0268673.ref040","article-title":"Evaluation of Low-dose Aspirin for the Prevention of Recurrent Spontaneous Preterm Labour (the APRIL study): a multicentre, randomised, double-blinded, placebo-controlled trial.","author":"AJEMC Landman","year":"2021","journal-title":"PLoS Med, forthcoming"},{"issue":"10220","key":"pone.0268673.ref041","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":"MK Hoffman","year":"2020","journal-title":"Lancet (London, England)."},{"issue":"1","key":"pone.0268673.ref042","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ajog.2018.03.018","article-title":"Optimal aspirin dosing for preeclampsia prevention","volume":"219","author":"AL Seidler","year":"2018","journal-title":"American journal of obstetrics and gynecology"},{"issue":"9","key":"pone.0268673.ref043","doi-asserted-by":"crossref","first-page":"e24549","DOI":"10.1371\/journal.pone.0024549","article-title":"The human endogenous circadian system causes greatest platelet activation during the biological morning independent of behaviors","volume":"6","author":"FA Scheer","year":"2011","journal-title":"PloS one."},{"issue":"4","key":"pone.0268673.ref044","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3109\/09537104.2015.1107536","article-title":"Evening intake of aspirin is associated with a more stable 24-h platelet inhibition compared to morning intake: a study in chronic aspirin users","volume":"27","author":"JJ van Diemen","year":"2016","journal-title":"Platelets"},{"journal-title":"Procedureboek Kwaliteitscirkel","year":"2020","author":"NVOG","key":"pone.0268673.ref045"},{"issue":"9","key":"pone.0268673.ref046","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1097\/00005650-199609000-00002","article-title":"The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations","volume":"34","author":"DE Pathman","year":"1996","journal-title":"Med Care"},{"key":"pone.0268673.ref047","unstructured":"The Fetal Medicine Foundation [cited 2022 23rd of March]. Available from: https:\/\/fetalmedicine.org\/."},{"key":"pone.0268673.ref048","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.preghy.2019.03.005","article-title":"Prediction models for preeclampsia: A systematic review","volume":"16","author":"AC De Kat","year":"2019","journal-title":"Pregnancy Hypertens"},{"issue":"4","key":"pone.0268673.ref049","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1080\/10641955.2020.1777299","article-title":"Patients\u2019 perspective on aspirin during pregnancy: a survey","volume":"39","author":"JM Bij de Weg","year":"2020","journal-title":"Hypertens Pregnancy"},{"issue":"4","key":"pone.0268673.ref050","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.preghy.2016.08.232","article-title":"Aspirin adherence during high-risk pregnancies, a questionnaire study.","volume":"6","author":"CN Abheiden","year":"2016","journal-title":"Pregnancy Hypertens"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T22:13:03Z","timestamp":1700691183000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268673"}},"subtitle":[],"editor":[{"given":"Sara","family":"Ornaghi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,9]]},"references-count":50,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0268673","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,6,9]]}}}