Pregnancy hypertension · 2025
The timing of discontinuation of low-dose aspirin and postpartum hemorrhage risk.
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Badarna Muhammad, Hoffman Neta, Stern Shai, Kayal Raneen Sawaid, Aiob Ala, Lowenstein Lior, Sgayer Inshirah
Аннотация
OBJECTIVES: To evaluate associations of the timing of low-dose aspirin (LDA) discontinuation, with postpartum hemorrhage (PPH) and bleeding-related complications.
STUDY DESIGN: A retrospective cohort study was conducted at a tertiary medical center, of pregnant women who received LDA and delivered beyond 23 weeks of gestation. The women were categorized as having discontinued LDA ≤7 days or >7 days before delivery. Exclusion criteria were: severe fetal malformations, intrauterine fetal death, multiple pregnancy, pre-conceptional use of LDA, and missing data on the timing of LDA discontinuation.
MAIN OUTCOME MEASURES: The primary outcome was a composite bleeding outcome that included at least one of the following: PPH, blood loss greater than 1000 ml, the need for blood product transfusions, and a drop in hemoglobin of ≥4 g/dL after delivery.
RESULTS: Among 763 women, 192 (25.2 %) discontinued LDA ≤7 days of delivery, while 571 (74.8 %) discontinued >7 days before delivery. Comparing these groups, PPH rates, severe blood loss, and transfusion requirements did not differ significantly, nor did the composite bleeding outcome (9.9 % vs. 8.6 %, p = 0.661). Placental abruption occurred more frequently among women who discontinued LDA ≤7 days compared to >7 days before delivery (5.2 % vs. 1.1 %, p = 0.002). However, in multivariate analysis, the timing of LDA discontinuation was not independently associated with an increased risk of placental abruption.
CONCLUSION: The timing of LDA discontinuation was not associated with increased PPH or major bleeding complications.
STUDY DESIGN: A retrospective cohort study was conducted at a tertiary medical center, of pregnant women who received LDA and delivered beyond 23 weeks of gestation. The women were categorized as having discontinued LDA ≤7 days or >7 days before delivery. Exclusion criteria were: severe fetal malformations, intrauterine fetal death, multiple pregnancy, pre-conceptional use of LDA, and missing data on the timing of LDA discontinuation.
MAIN OUTCOME MEASURES: The primary outcome was a composite bleeding outcome that included at least one of the following: PPH, blood loss greater than 1000 ml, the need for blood product transfusions, and a drop in hemoglobin of ≥4 g/dL after delivery.
RESULTS: Among 763 women, 192 (25.2 %) discontinued LDA ≤7 days of delivery, while 571 (74.8 %) discontinued >7 days before delivery. Comparing these groups, PPH rates, severe blood loss, and transfusion requirements did not differ significantly, nor did the composite bleeding outcome (9.9 % vs. 8.6 %, p = 0.661). Placental abruption occurred more frequently among women who discontinued LDA ≤7 days compared to >7 days before delivery (5.2 % vs. 1.1 %, p = 0.002). However, in multivariate analysis, the timing of LDA discontinuation was not independently associated with an increased risk of placental abruption.
CONCLUSION: The timing of LDA discontinuation was not associated with increased PPH or major bleeding complications.