|
|
INTRAUTERINE GROWTH RESTRICTION |
Lancet. 1991 Jun 15;337(8755):1427-31.
Prevention of fetal growth retardation with low-dose aspirin: findings of
the EPREDA trial.
Uzan S, Beaufils M, Breart G, Bazin B, Capitant C, Paris J.
Service de Gyn?ologie-Obst?rique, INSERM U 149, Paris, France.
The efficacy of low-dose aspirin in preventing fetal growth retardation was
tested in a randomised, placebo-controlled, double-blind trial. A secondary
aim was to find out whether dipyridamole improves the efficacy of aspirin.
323 women at 15-18 weeks' amenorrhoea were selected at twenty-five
participating centres on the basis of fetal growth retardation and/or fetal
death or abruptio placentae in at least one previous pregnancy. They were
randomly allocated to groups receiving placebo, 150 mg/day aspirin, or 150
mg/day aspirin plus 225 mg/day dipyridamole, for the remainder of the
pregnancy. In the first phase of the trial all actively treated patients (n
= 156) were compared with the placebo group (n = 73). Mean birthweight was
significantly higher in the treated than in the placebo group (2751 [SD 670]
vs 2526 [848] g; difference 225 g [95% CI 129-321 g], p = 0.029) and the
frequency of fetal growth retardation in the placebo group was twice that in
the treated group (19 [26%] vs 20 [13%]; p less than 0.02). The frequencies
of stillbirth (4 [5%] vs 2 [1%]) and abruptio placentae (6 [8%] vs 7 [5%])
were also higher in the placebo than in the treated group. The benefits of
aspirin treatment were greater in patients with two or more previous poor
outcomes than in those with only one. In the second analysis, of aspirin
only (n = 127) vs aspirin plus dipyridamole (n = 119), no significant
differences were found. There was no excess of maternal or neonatal
side effects in the aspirin-treated patients.
|
|
