CoChat
Sign Up
Cited by 2,287Pregnancy and preeclampsia studiesNeurological Complications and SyndromesNeonatal and fetal brain pathology

Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia

Open access
Rolnik, Daniel L., Wright, David, Poon, Liona C., O’Gorman, Neil, Syngelaki, Argyro, de Paco Matallana, Catalina, Akolekar, Ranjit, Cicero, Simona +12 more·2017·New England Journal of Medicine
DOI 10.1056/nejmoa1704559
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia. METHODS: In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. The analysis was performed according to the intention-to-treat principle. RESULTS: A total of 152 women withdrew consent during the trial, and 4 were lost to follow up, which left 798 participants in the aspirin group and 822 in the placebo group. Preterm preeclampsia occurred in 13 participants (1.6%) in the aspirin group, as compared with 35 (4.3%) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). Results were materially unchanged in a sensitivity analysis that took into account participants who had withdrawn or were lost to follow-up. Adherence was good, with a reported intake of 85% or more of the required number of tablets in 79.9% of the participants. There were no significant between-group differences in the incidence of neonatal adverse outcomes or other adverse events. CONCLUSIONS: Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a lower incidence of this diagnosis than placebo. (Funded by the European Union Seventh Framework Program and the Fetal Medicine Foundation; EudraCT number, 2013-003778-29 ; Current Controlled Trials number, ISRCTN13633058 .).

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejmoa1704559

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The finding of low-dose aspirin benefit was not confirmed in the ASPRE trial, which was primarily designed for preterm preeclampsia prevention.

    “However, this finding was not confirmed in the Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial, which was primarily designed for preterm preeclampsia prevention.74,75”

    From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [74]

    The Primary Outcome section reports significantly less preterm preeclampsia with aspirin than placebo (1.6% versus 4.3%; P = 0.004), contrary to the claim that the trial did not confirm an aspirin benefit. The Discussion confirms that preterm preeclampsia was the trial’s primary outcome; it notes no significant differences for other outcomes, but says the trial was not adequately powered for them. (LLM, conf=0.89)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Low-dose aspirin <100 mg is not effective in reducing preeclampsia, and low-dose aspirin >100 mg is required.

    “However, a meta-analysis and an additional trial demonstrate that low-dose aspirin <100 mg is not effective in reducing preeclampsia.Low-dose aspirin >100 mg is required (117-119).”

    From 15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [118]

    The Discussion reports that 150 mg/day reduced preterm preeclampsia in women at high risk, and the introductory passage reports a greater reduction with doses of 100 mg or more. The trial did not compare doses, however, and the paper does not establish that doses below 100 mg are ineffective or that a dose above 100 mg is required. No page numbers are provided for these passages. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In women at high-risk of preeclampsia who received low-dose aspirin from 11 to 14 gestational weeks until 36 weeks, the risk of developing preeclampsia was significantly decreased (OR: 0.38; 95% CI: 0.20-0.74; p = 0.004).

    “This is based on the ASPRE study, which showed that in women at high-risk of preeclampsia who received low-dose aspirin from 11 to 14 gestational weeks until 36 weeks, the risk of developing preeclampsia was significantly decreased (OR: 0.38; 95% CI: 0.20–0.74; p = 0.004) [78].”

    From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [78]

    The Primary Outcome section reports the stated odds ratio, confidence interval, and P value for preterm preeclampsia after aspirin treatment. The claim omits “preterm,” making the result sound applicable to preeclampsia generally; the Discussion says aspirin did not reduce the incidence of term preeclampsia. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • The ASPRE trial demonstrated that aspirin reduced the incidence of pre-eclampsia compared with placebo in a population identified as high risk using a first trimester screening test, but was underpowered to detect an effect on FGR/SGA and stillbirth.

    “The recent ASPRE trial demonstrated that administration of aspirin to a population identified as high risk using a first trimester screening test reduced the incidence of pre-eclampsia compared with placebo [17], but was underpowered to detect an effect on FGR/SGA and stillbirth.”

    From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [17]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. [3]3. Irgens HU, Reisaeter L, Irgens LM, Lie RT. Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ 2001; 323: 1213-7.
  2. [11]11. National Collaborating Centre for Women's and Children's Health (UK). Hy- pertension in pregnancy: the management of hypertensive disorders during preg- nancy. London: RCOG Press, 2010.
  3. [23]23. Van Buuren S, Groothuis-Oudshoorn K. Multivariate imputation by chained equations in R. J Stat Softw 2011; 45: 1-67.

Cited by

Sorted by citations

Related

Authors
Rolnik, D. L., Wright, D., Poon, L. C., O’Gorman, N., Syngelaki, A., de Paco Matallana, C., Akolekar, R., Cicero, S., Janga, D., Singh, M., Molina, F. S., Persico, N., Jani, J. C., Plasencia, W., Papaioannou, G., Tenenbaum-Gavish, K., Meiri, H., Gizurarson, S., Maclagan, K., & Nicolaides, K. H.
Affiliations
  • Université Libre de Bruxelles (BE)
  • King's College Hospital (GB)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2017-08-17
Volume
377
Issue
7
Pages
613-622
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1704559
OpenAlex
W2730504020
Cited by
2,287
References
24
Citations by year
2026: 252 · 2025: 277 · 2024: 231 · 2023: 274 · 2022: 257 · 2021: 249 · 2020: 265 · 2019: 212 · 2018: 196 · 2017: 69 · 2015: 1 · 2013: 1
FWCI
238.94
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
  • RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
Funders
  • Imperial College London
  • Imperial College Healthcare NHS Trust
  • University College London
  • European Commission (FP7-HEALTH-2013INNOVATION, 601852, HEALTH-2013)
  • Fetal Medicine Foundation
  • FP7 Health (601852)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Keywords
low-dose aspirin, preterm preeclampsia, high-risk pregnancy, preeclampsia prevention, singleton pregnancy, drug safety in pregnancy, adverse neonatal outcomes
MeSH terms
Adult, Aspirin, Double-Blind Method, Female, Humans, Infant, Newborn, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk, Incidence, Kaplan-Meier Estimate, Intention to Treat Analysis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review