The Journal of clinical endocrinology and metabolism, 102(5), 1495-1504, 2017
Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial
Lindsey A Sjaarda, Rose G Radin, Robert M Silver
Sunni L Mumford, Wilcox B , Brian D. Wilcox , Noya Galai, Neil J Perkins, Joseph B Stanford, Enrique F Schisterman, Emily M Mitchell, Jean Wactawski-Wende
Author affiliations (7)
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentROR
Department of Epidemiology and Environmental Health, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.ROR
Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation.
Objective
To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy.
Design
Stratified secondary analysis of a multicenter, block-randomized, double-blind, placebo-controlled trial.
Setting
Four US academic medical centers, 2007 to 2012.
Participants
Healthy women aged 18 to 40 years (N = 1228) with one to two prior pregnancy losses actively attempting to conceive.
Intervention
Preconception-initiated, daily LDA (81 mg) or matching placebo taken up to six menstrual cycles attempting pregnancy and through 36 weeks' gestation in women who conceived.
Main Outcome Measures
Confirmed pregnancy, live birth, and pregnancy loss were compared between LDA and placebo, stratified by tertile of preconception, preintervention serum high-sensitivity C-reactive protein (hsCRP) (low, <0.70 mg/L; middle, 0.70 to <1.95 mg/L; high, ≥1.95 mg/L).
Results
Live birth occurred in 55% of women overall. The lowest pregnancy and live birth rates occurred among the highest hsCRP tertile receiving placebo (44% live birth). LDA increased live birth among high-hsCRP women to 59% (relative risk, 1.35; 95% confidence interval, 1.08 to 1.67), similar to rates in the lower and mid-CRP tertiles. LDA did not affect clinical pregnancy or live birth in the low (live birth: 59% LDA, 54% placebo) or midlevel hsCRP tertiles (live birth: 59% LDA, 59% placebo).
Conclusions
In women attempting conception with elevated hsCRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates compared with women without inflammation and reduce hsCRP elevation during pregnancy.
PMID 28323989 28323989 DOI 10.1210/jc.2016-2917 10.1210/jc.2016-2917 Sjaarda et al. 2017, Sjaarda 2017
Cite this article
Sjaarda, L. A., Radin, R. G., Silver, R. M., Mitchell, E., Mumford, S. L., Wilcox, B., Galai, N., Perkins, N. J., Wactawski-Wende, J., Stanford, J. B., & Schisterman, E. F. (2017). Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial. The Journal of clinical endocrinology and metabolism, 102(5), 1495-1504. https://doi.org/10.1210/jc.2016-2917
Sjaarda LA, Radin RG, Silver RM, Mitchell E, Mumford SL, Wilcox B, et al. Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial. J Clin Endocrinol Metab. 2017;102(5):1495-1504. doi:10.1210/jc.2016-2917
Sjaarda, L. A., et al. "Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial." The Journal of clinical endocrinology and metabolism, vol. 102, no. 5, 2017, pp. 1495-1504.
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Schisterman EF et al., 2015·J Clin Endocrinol Metab·
Open Access
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Anti-Infective and Anti-Inflammatory Agents · Nonsteroidal Anti-Inflammatory Drugs
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Anti-Infective and Anti-Inflammatory Agents · Nonsteroidal Anti-Inflammatory Drugs
Schisterman EF et al., 2013·Paediatr Perinat Epidemiol·
Open Access
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