(752) Universal use of aspirin prenatally: Benefit to patients at high-risk for preeclampsia

Objective: The objective of this study was to evaluate if aspirin (ASA) administration to all obstetric patients increases use. Specifically, we assessed compliance rates in patients at high-risk for preeclampsia.

Study Design: A prospective cohort of all obstetric patients who initiated prenatal care from January 2022 – December 2022 at a federally funded health care center and delivered at an academic health institution in New York. ASA 81mg daily was prescribed to all patients initiating care from 12 to 28 weeks’ gestation beginning January 2022. Compliance with ASA use was verified at each prenatal visit. Patients who had a contraindication to ASA use, missed abortion, initiated care after 28 weeks’ gestation and/or transferred care were excluded. Data was compared to a retrospective cohort of all obstetric patients from January 2021 – December 2021. The included patients were divided into two groups: pre- and post-intervention. Patient characteristics were obtained from the electronic medical record system. In addition to comparing maternal ASA use between the pre- and post-intervention groups, a separate analysis was performed to assess ASA use among patients at high risk for preeclampsia based on ACOG and USPTF guidelines.

Results: A total of 765 patients were included: 373 pre-intervention and 392 post-intervention. Patients were predominately Hispanic, Spanish-speaking, single, and maternal age < 35 years old. The rate of ASA use increased significantly when comparing the pre-intervention to the post-intervention group [8% (n= 30) vs 77% (n=301), p< 0.001; Graph]. 228 patients were classified as high-risk for developing pre-eclampsia: 77 pre-intervention and 151 post-intervention. The rate of ASA use in the high-risk post-intervention group increased [18% (n= 14) vs 84% (n=127), p< 0.001].

Conclusion: When ASA is administered universally, patients at high-risk for preeclampsia were four times more likely to adhere to use. Further studies are needed to evaluate preeclampsia outcomes in this patient population.