{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:50:39Z","timestamp":1793847039601,"version":"4.6.1"},"reference-count":13,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0215_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Low-dose aspirin (LDA) prophylaxis is an evidence-based intervention that reduces preeclampsia risk, yet adherence remains suboptimal in underserved populations due to inconsistent risk assessment and communication gaps. This study evaluated the impact of a universal LDA protocol at a Federally Qualified Health Center (FQHC) serving a socially vulnerable population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0215_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients initiating prenatal care between 12 and 28\u00a0weeks of gestation were included. A retrospective cohort from 2021 (pre-intervention) was compared to a prospective cohort from 2022 (post-intervention). The intervention prescribed daily LDA to all eligible patients. Adherence was defined as provider-documented patient use during at least one follow-up visit and at delivery, an indirect measure relying on patient report and provider documentation. The primary outcome was LDA adherence. Secondary outcomes included preeclampsia with and without severe features and postpartum hemorrhage requiring blood transfusion. Multivariable logistic regression adjusted for maternal age, pregestational diabetes, and chronic hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0215_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 775 patients, LDA adherence increased from 8.7\u202f% pre-intervention to 75.0\u202f% post-intervention (p&lt;0.001). The incidence of preeclampsia with severe features decreased significantly (OR 0.14, 95\u202f% CI 0.04\u20130.37). In high-risk patients, adherence rose from 8.9 to 70.9\u202f% (p&lt;0.001) with a similar reduction in severe preeclampsia (OR 0.16, 95\u202f% CI 0.05\u20130.44). No significant changes were observed in preeclampsia without severe features or postpartum hemorrhage requiring transfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0215_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of a universal LDA protocol in a high-risk, underserved population markedly improved adherence and reduced severe preeclampsia without increasing hemorrhage risk, offering a practical, low-cost strategy to improve maternal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0215","type":"journal-article","created":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T07:58:17Z","timestamp":1760255897000},"page":"282-287","source":"Crossref","is-referenced-by-count":4,"title":["Implementation of a universal low-dose aspirin protocol for the prevention of preeclampsia in a federally qualified health center"],"prefix":"10.1515","volume":"54","author":[{"given":"Jaclyn","family":"Del Pozzo","sequence":"first","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Insaf","family":"Kouba","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Jackson","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Green","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Demertzis","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quratulain","family":"Zeeshan","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"},{"name":"Sun River Health , Brentwood , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-6928","authenticated-orcid":false,"given":"Matthew J.","family":"Blitz","sequence":"additional","affiliation":[{"name":"Northwell , New Hyde Park , NY , USA"},{"name":"Department of Obstetrics and Gynecology , South Shore University Hospital , Bay Shore , NY , USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell , Hempstead , NY , USA"},{"name":"5799 Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health , Manhasset , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2026051215204218837_j_jpm-2025-0215_ref_001","doi-asserted-by":"crossref","unstructured":"LeFevre, ML, U.S. Preventi, ve Services Task Force. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. preventive services task force recommendation statement. Ann Intern Med 2014;161:819\u201326. https:\/\/doi.org\/10.7326\/M14-1884.","DOI":"10.7326\/M14-1884"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_002","doi-asserted-by":"crossref","unstructured":"ACOG committee opinion no. 743: low-dose aspirin use during pregnancy. Obstet Gynecol 2018;132:e44\u201352. https:\/\/doi.org\/10.1097\/AOG.0000000000002708.","DOI":"10.1097\/AOG.0000000000002708"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_003","doi-asserted-by":"crossref","unstructured":"Caritis, S, Sibai, B, Hauth, J, Lindheimer, M, Klebanoff, M, Thom, E, et al.. Low-dose aspirin to prevent preeclampsia in women at high risk. N\u00a0Engl J Med 1998;338:701\u20135. https:\/\/doi.org\/10.1056\/NEJM199803123381101.","DOI":"10.1056\/NEJM199803123381101"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_004","doi-asserted-by":"crossref","unstructured":"Shanmugalingam, R, Mengesha, Z, Notaras, S, Liamputtony, P, Fulcher, I, Gaksoo, L, et al.. Factors that influence adherence to aspirin therapy in the prevention of preeclampsia amongst high-risk pregnant women: a mixed method analysis. PLoS One 2020;15:e0229622. https:\/\/doi.org\/10.1371\/journal.pone.0229622.","DOI":"10.1371\/journal.pone.0229622"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_005","doi-asserted-by":"crossref","unstructured":"Martinez-King, LC, Machiorlatti, M, Ogburn, T, Salcedo, J. Physician\u2019s\u00a0knowledge and practices surrounding low-dose aspirin\u00a0for preeclampsia risk reduction. 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Am J Perinatol 2023;40:1390\u20137. https:\/\/doi.org\/10.1055\/a-2096-5199.","DOI":"10.1055\/a-2096-5199"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_008","doi-asserted-by":"crossref","unstructured":"Ogrinc, G, Davies, L, Goodman, D, Batalden, PB, Davidoff, F, Stevens, D. SQUIRE 2.0 (standards for QUality improvement reporting excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf 2016;25:986\u201392. https:\/\/doi.org\/10.1136\/bmjqs-2015-004411.","DOI":"10.1136\/bmjqs-2015-004411"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_009","doi-asserted-by":"crossref","unstructured":"Mone, F, Mulcahy, C, McParland, P, McAuliffe, FM. Should we recommend universal aspirin for all pregnant women? Am J Obstet Gynecol 2017;216:141.e1\u20135. https:\/\/doi.org\/10.1016\/j.ajog.2016.09.086.","DOI":"10.1016\/j.ajog.2016.09.086"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_010","doi-asserted-by":"crossref","unstructured":"Souter, V, Painter, I, Sitcov, K, Khalil, A. Propensity score analysis of low-dose aspirin and bleeding complications in pregnancy. Ultrasound Obstet Gynecol 2024;63:81\u20137. https:\/\/doi.org\/10.1002\/uog.27472.","DOI":"10.1002\/uog.27472"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_011","doi-asserted-by":"crossref","unstructured":"Jiang, Y, Chen, Z, Chen, Y, Wei, L, Peng, G, Zhang, J, et al.. Low-dose aspirin use during pregnancy may be a potential risk for postpartum hemorrhage and increased blood loss: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023;5:100878. https:\/\/doi.org\/10.1016\/j.ajogmf.2023.100878.","DOI":"10.1016\/j.ajogmf.2023.100878"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_012","doi-asserted-by":"crossref","unstructured":"Roberge, S, Gigu\u00e8re, Y, Villa, P, Nicolaides, K, Vainio, M, Forest, JC, et al.. Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia: a systematic review and meta-analysis. Am J Perinatol 2012;29:551\u20136. https:\/\/doi.org\/10.1055\/s-0032-1310527. Erratum in: Am J Perinatol. 2014;31(6):e3.","DOI":"10.1055\/s-0033-1343351"},{"key":"2026051215204218837_j_jpm-2025-0215_ref_013","doi-asserted-by":"crossref","unstructured":"Roberge, S, Bujold, E, Nicolaides, KH. Aspirin for the prevention of preterm and term preeclampsia: systematic review and metaanalysis. 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