(929) Low-Dose Aspirin Usage during Pregnancy: A Retrospective Structured Electronic Medical Record Data Study

To examine the impact of reminder software to prescribe low-dose aspirin when indicated at the point-of-care on aspirin prescription in high-risk individuals.

Study Design:

This was a retrospective study of individuals who were eligible for low-dose aspirin during pregnancy according to ACOG guidelines from 2019 to 2023 in the State of Connecticut. Data were extracted from centers that used Dorsata Prenatal with its Care Plan technology within the athenahealth EMR. Dorsata Prenatal is a software that notifies physicians within their workflow when individuals are clinically eligible for low-dose aspirin. We limited the analysis to individuals who met ACOG criteria for low-dose aspirin. The primary outcome was the prescription of low-dose aspirin. The secondary outcomes were preterm delivery < 32 weeks, preterm delivery < 28 weeks, postpartum hemorrhage, cesarean delivery, eclampsia, gestational hypertension, preeclampsia, and low birthweight. Outcomes were compared between individuals whose physicians acknowledged the Care Plan within Dorsata Prenatal and those whose physicians did not acknowledge the Care Plan. Logistic regression was used to obtain crude odds ratio (cOR) with 95% confidence intervals.

Results:

Of 41963 individuals, 23258 had their Care Plan acknowledged and 18705 did not. Table 1 shows the cORs for each outcome. Compared to individuals whose Care Plan was not acknowledged, those with an acknowledged Care Plan had increased odds of being started on low-dose aspirin (cOR 5.79 [5.40-6.20]), cesarean delivery (cOR 1.07 [1.03-1.12]), and gestational hypertension (cOR 1.32 [1.16-1.49]), but had decreased odds of preterm delivery< 32 weeks (cOR 0.42 [0.39-0.46]), preterm delivery < 28 weeks (cOR 0.36 [0.33-0.40]), and postpartum hemorrhage (cOR 0.77 [0.65-0.92]).

Conclusion:

Dorsata Prenatal Care Plan can enhance the prescription of low-dose aspirin for individuals who meet the criteria for low-dose aspirin.