Comparison of Fetomaternal Outcomes Between Standard Versus High-Dose Aspirin in Patients With High Risk of Preeclampsia

Sabahat Noor; Aqsa Farooq; Sobia Mazhar

doi:10.54112/bcsrj.v6i5.2247

Authors

Sabahat Noor Department of Gynecology & Obstetrics, Ibn-E-Siena Hospital Multan, Pakistan
Aqsa Farooq Department of Gynecology & Obstetrics, Ibn-E-Siena Hospital Multan, Pakistan
Sobia Mazhar Department of Gynecology & Obstetrics, Ibn-E-Siena Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.2247

Keywords:

Aspirin; Pre-Eclampsia; Pregnancy, High-Risk; Pregnancy Outcome; Birth Weight; Stillbirth

Abstract

Preeclampsia remains a major cause of maternal and neonatal morbidity and mortality, particularly in low- and middle-income countries. Aspirin prophylaxis is recommended for pregnant women at high risk of preeclampsia, but the optimal preventive dose remains under investigation. This study compared fetomaternal outcomes between standard-dose aspirin and high-dose aspirin in women at high risk of preeclampsia. Objective: To compare the effects of standard-dose aspirin (75 mg/day) and high-dose aspirin (150 mg/day) on maternal and neonatal outcomes in pregnant women at high risk of preeclampsia. Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Ibn-e-Siena Hospital, Multan, from 11 October 2024 to 11 April 2025. A total of 224 pregnant women aged 18-45 years with singleton or multiple pregnancies at 11-14 weeks of gestation and identified as high risk for preeclampsia were enrolled and equally randomized into two groups. Group A received aspirin 75 mg daily, while Group B received aspirin 150 mg daily, continued until 36 weeks’ gestation. The primary maternal outcome was development of preeclampsia. Fetal outcomes included stillbirth and neonatal birth weight. Data were analyzed using SPSS version 23, with p≤0.05 considered statistically significant. Results: Baseline maternal and obstetric characteristics were comparable between the two groups. Overall, preeclampsia developed in 11.6% of participants. The frequency of preeclampsia was significantly lower in the high-dose aspirin group than in the standard-dose group (7.1% vs 16.1%; p=0.038). Stillbirth occurred less frequently in the high-dose group (2.7% vs 6.3%), although this difference was not statistically significant (p=0.197). Mean neonatal birth weight was significantly higher in the high-dose aspirin group compared with the standard-dose group (2875 ± 485 g vs 2690 ± 510 g; p=0.006). Stratified analyses showed greater benefit of high-dose aspirin among women with BMI ≥35 kg/m², multiparity, and singleton pregnancies. Conclusion: High-dose aspirin (150 mg/day) was more effective than standard-dose aspirin (75 mg/day) in reducing the frequency of preeclampsia and improving neonatal birth weight in women at high risk of preeclampsia. High-dose aspirin may be considered a more effective prophylactic regimen in this high-risk population.

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