ASPRE

Aspirin for Evidence-Based Preeclampsia Prevention trial

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 1,776 women with singleton pregnancies at high risk of preterm pre-eclampsia on first-trimester screening, aspirin 150 mg daily from 11–14 until 36 weeks reduced delivery with pre-eclampsia before 37 weeks compared with placebo.

1 776

Schéma

Double-blind, placebo-controlled RCT

Critère

Delivery with pre-eclampsia before 37 weeks' gestation

Pertinence

Résultat1.6 % vs 4.3 % (odds ratio 0.38; 95 % CI 0.20–0.74; p=0.004). No significant difference in neonatal adverse outcomes.

Rolnik DL, Wright D, Poon LC, et al. N Engl J Med. 2017;377(7):613-622. 10.1056/NEJMoa1704559

Discussion et critique

The benefit is confined to preterm pre-eclampsia — term disease and hard perinatal outcomes were not significantly reduced — and the trial rests on few events. It established both the effective dose (150 mg, higher than the 75–81 mg used before) and the value of algorithm-based first-trimester screening.