SOMANZ Mini Oral Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Serum biomarkers (PlGF & sFlt-1), Uterine artery Doppler and fetomaternal outcome with 75mg and 150mg of LDA in women at high risk for developing preeclampsia - A prospective cohort study (123000)

Sasirekha Rengaraj 1 , Gayathry Ashok 1 , Nivedita Nanda 1
  1. Jipmer, Puducherry, PONDICHERRY, India

Background: Low-dose aspirin (LDA) helps prevent pre-eclampsia (PE), but the optimal dose is debated.1-4 We studied uterine artery Doppler and serum biomarkers (PlGF, sFlt-1) in high-risk women and compared maternal and perinatal outcomes between those on 75 mg and 150 mg LDA.

Methods: This prospective cohort study was conducted at a tertiary care centre in Southern India. Women at high risk of developing pre-eclampsia (GESTOSIS score ≥3) who started low-dose aspirin (LDA) before 16 weeks were divided into Group 1 (75 mg) and Group 2 (150 mg). Between 28–32 weeks of gestation, uterine artery pulsatility index (PI) and serum biomarkers were assessed. Participants were followed until the delivery

Results: A total of 179 women in Group 1 and 180 women in Group 2 were studied. Maternal characteristics and Gestosis scores were similar between groups. Uterine artery PI, sFlt-1, PlGF, and sFlt-1/PlGF ratio showed no significant differences. The incidence of pre-eclampsia (PE) was similar (Group 1: 4.4%, Group 2: 6.1%, p=0.48), but preterm PE was significantly higher in Group 2 (p=0.01, 95% CI; 6.3-12.3). Maternal outcomes were comparable, but preterm birth (PTB) before 34 weeks, fetal growth restriction (FGR), and 5' APGAR <7 were significantly more in Group 2.

Conclusion: Maternal uterine artery PI and serum biomarkers were similar in women while on 75 mg and 150 mg of LDA.  Though the development of pre-eclampsia (PE) was comparable between both doses, neonates in the higher-dose (150 mg) group were at increased risk of FGR, prematurity, and lower 5-minute APGAR scores.

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  4. Ghesquiere L, Guerby P, Marchant I, Kumar N, Zare M, Foisy MA, Roberge S, Bujold E. Comparing aspirin 75 to 81 mg vs 150 to 162 mg for prevention of preterm preeclampsia: systematic review and meta-analysis. American journal of obstetrics & gynecology MFM. 2023 Jul 1;5(7):101000.