This story from HealthDay does a good job of explaining the benefits, harms and quality of the evidence from the study, which assessed aspirin’s ability to prevent preeclampsia in certain women who are deemed high risk.
However, we wish the story had made it more clear that this benefit was only significant in births that occurred before 37 weeks of pregnancy. After 37 weeks, the preeclampsia rates were similar in both groups–so it was of minimal to no benefit women in this timeframe, which is when most preeclampsia occurs.
Prevention of pre-term preeclampsia is thought to be particularly beneficial because it may reduce complications from premature births. But women and babies can still be harmed when preeclampsia develops after 37 weeks.
We also took issue with this quote from the lead researcher: “This condition is, to a great extent, preventable.”
This is only somewhat true for pre-term preeclampsia among women who have been identified to be high-risk and receive treatment. Most women who develop preeclampsia have no risk factors and therefore will probably not be taking aspirin to prevent it from occurring. And even among high-risk women, it only reduces risk–it doesn’t eliminate it.
Preeclampsia is one of the top global causes of maternal and infant mortality. If taking a low dose of a readily available and inexpensive drug during pregnancy can reduce the risk of pre-term complications among high-risk women — as this story and study suggests it will — then this will probably save many lives.
We’ll consider this N/A since generic aspirin is very affordable. Still, we never think it’s a bad idea to acknowledge the cost of a treatment. Also, there is the potential for significant cost savings to individuals and society by reducing the financial burden of treating pregnancy and childbirth complications using only a very affordable medication. We’d be curious to see an estimate.
The story offered, “Just 13 women in the aspirin group developed preeclampsia, while 35 women in the placebo group developed the complication, the findings showed.” We appreciated that this was given in absolute terms, instead of just percentages, so we could get clearer sense of the impact.
However, the story does not make it clear that this is referring to women who delivered at or before 37 weeks.
This is important because for deliveries that occurred after 37 weeks (which is when most preeclampsia develops), there was no statistically significant benefit to taking aspirin. In this group, preeclampsia affected 53 of the women in the aspirin group and 59 in the placebo group.
The story says, “There were no serious side effects for expectant mothers, or adverse events for the babies related to aspirin use during pregnancy, the researchers noted.” To its credit, it also adds, “However, as with all drugs, women should talk to their doctor about the use of aspirin in pregnancy before taking up this regimen, because aspirin does increase the risk for bleeding.”
The story explains that the clinical trial in question was a “double-blind, placebo-controlled study” involving 1,600 women who “came from 13 different maternity hospitals across Europe and Israel.” Furthermore, it provides some detail as to how researchers determined the risk status of the women in the study: “Instead of relying solely on standard risk factors, the researchers combined those risk factors with measurements of maternal blood flow, blood pressure and two hormones produced by the placenta. They used an algorithm they designed to combine all those factors to select women who they believed were at a high risk of preeclampsia.”
It’s not clear how reliable that algorithm is, though.
This story doesn’t appear to commit disease-mongering. We do think the story would have been stronger if it had discussed the prevalence of preeclampsia, which is thought to affect about 5-8% of all pregnancies, and is one of the most common cause of maternal deaths globally.
The story included an independent source and we could find no conflicts of interest.
There are no known treatment alternatives to preventing preeclampsia.
As mentioned above, aspirin is ubiquitous in the modern world so there is hardly a problem with its availability.
What makes this story, and the trial, novel is that this is a higher dosage of aspirin — although still a low dose — than had been suggested for use in previous studies. And as a commonly available drug, aspirin seems to offer an easy, and cheap, way to reduce a patient’s risk of developing preeclampsia.
This story does not appear to rely on a news release.
Systematic, Criteria-Driven
With the discontinuation of @HealthNewsRevu, there's a genuine concern that well-written and researched "reality checks" in healthcare are not economically interesting. This should be disconcerting to anyone, and yet I'm only seeing more and more piling into "promising findings"
Thanks for ALL you do and have done, Gary. https://t.co/93K4hzQXZj
Thanks for sharing this with all of us today, @garyschwitzer @HealthNewsRevu
A nice gift.
#healthcare #healthcarenews #journalism #reporting #factsmatter #truthmatters https://t.co/hNHdZDl2rc
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