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Hypertension

Poster Session 1

(349) Antenatal aspirin prescription following the United States Preventive Services Task Force’s (USPSTF) 2021 practice update

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Ashten Waks, MD, MSPH (she/her/hers)

Fellow Physician
University of California Irvine
Long Beach, CA, United States

Coauthor(s)

Gina F. Milone, MD (she/her/hers)

Fellow Physician
University of California Irvine
Irvine, CA, United States
Megan C. Oakes, MD, MSCI (she/her/hers)

Maternal-Fetal Medicine
MemorialCare Miller Children's and Women's Hospital, Long Beach
Long Beach, CA, United States

Objective: To compare the odds of antenatal aspirin prescription between patients with moderate risk factors for preeclampsia and patients with high risk factors for preeclampsia, as defined by the USPSTF.

Study Design: A retrospective cohort study of all pregnant patients with a documented prenatal care visit prior to 16 weeks’ gestation and delivered in our health care system between 1/1/2021 – 12/31/2022. Patients’ preeclampsia risk was stratified according to 2021 USPSTF guidance using data from the initial prenatal visit. The primary outcome was appropriate prescription of antenatal aspirin, defined as prescription by 16 weeks’ gestation to any patient with 1 high risk factor or 2 or more moderate risk factors for preeclampsia, and assessed using chi-square tests. Odds of correct antenatal aspirin prescription were also compared between risk groups using log-binomial regression.

Results: Of 1325 patients, 167 (12.6%) were found to have 1 or more high risk factor for preeclampsia and 316 (23.8%) were found to have 2 or more moderate risk factors for preeclampsia. Patients with just 1 high risk factor were significantly more likely to be prescribed antenatal aspirin than those with a combination of moderate risk factors (76.1% vs 38.9%, p < 0.05). The odds of correct antenatal aspirin prescription were over 5 times greater among patients with at least 1 high risk factor relative to those with multiple moderate risk factors (OR = 5.02, 95% CI 3.30 – 7.66). Adjusted for covariates of maternal age, parity, and blood pressure at the initial prenatal visit, the odds of antenatal aspirin prescription were unchanged between groups (aOR = 5.36, 95% CI 3.32 – 8.63).

Conclusion: Since publication of the USPSTF’s 2021 practice update on aspirin use for preeclampsia prophylaxis, less than 50% of eligible patients in our health care system have been correctly prescribed this medication. This trend was more pronounced among patients considered moderate risk, highlighting an opportunity for healthcare provider education on the utility of aspirin in this population.