Maternal serum thromboxane B2 concentrations do not predict improved outcomes in high-risk pregnancies in a low-dose aspirin trial - 09/09/11
The National Institute of Child Health Human Development Network of Maternal-Fetal Medicine Units
Abstract |
Objective: The aim of the study was too determine whether, in a low-dose aspirin trial in high-risk pregnancies, a decrease in maternal serum thromboxane B2 level predicted improved pregnancy outcomes. Study Design: This multicenter, randomized, double-blind trial included 2539 women, 1010 of whom had sufficient serum samples at enrollment and at 24 to 28 weeks’ gestation, 34 to 38 weeks’ gestation, or both to assess longitudinal changes in thromboxane B2 level and their effects on pregnancy outcomes. Women were randomly assigned between 13 and 26 weeks’ gestation to receive daily aspirin (60 mg) or placebo. Results: Overall and in all subgroups women assigned to receive aspirin had markedly lower maternal thromboxane B2 concentration values than did those assigned to receive a placebo (P = .0001). Changes in thromboxane levels were not, however, correlated with adverse pregnancy outcomes. Women with ≥50% reduction in maternal serum thromboxane B2 concentrations from baseline had occurrences of preeclampsia (P = .922), preterm birth (P = .375), small for gestational age neonates (P = .938), and grade III or IV intraventricular hemorrhage (P = 1.000) similar to those of women who had <50% reduction. Similar results were found for women with thromboxane B2 level decreases of <15 versus >15 ng/mL and women with thromboxane B2 level decreases to <10 versus ≥10, <5 versus ≥5, and <1 versus ≥1 ng/mL. Maternal thromboxane B2 concentrations at enrollment were also not predictive of adverse outcomes. Conclusion: Neither maternal serum thromboxane B2 concentrations at enrollment nor their subsequent reduction were predictive of adverse pregnancy outcomes in a low-dose aspirin trial. (Am J Obstet Gynecol 1998;179:1193-9.)
Le texte complet de cet article est disponible en PDF.Keywords : Low-dose aspirin, preeclampsia, thromboxane B2
Plan
 | From the University of Alabama at Birmingham,a the University of Tennessee, Memphis,b the University of Pittsburgh/Magee-Womens Hospital,c the Medical University of South Carolina,d the University of Chicago,e the National Institute of Child Health and Human Development,f The George Washington University Biostatistics Center,g Ohio State University,h the University of Southern California,i University of Cincinnati,j the Bowman Gray School of Medicine,k Wayne State University,l the University of Oklahoma,m and the Medical College of Virginia.n The members of the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units are listed at the end of the article. |
| Supported by grants HD19897, HD21410, HD21434, HD27860, HD27861, HD27869, HD27889, HD27905, HD27915, and HD27917 from the National Institute of Child Health and Human Development. |
 | Reprint requests: John C. Hauth, MD, University of Alabama at Birmingham, Department of Obstetrics and Gynecology, 618 S 20th St, Birmingham, AL 35233-7333. |
| 6/6/93257 |
Vol 179 - N° 5
P. 1193-1199 - novembre 1998 Retour au numéro
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