LOW-DOSE ASPIRIN PROPHYLAXIS IN PREGNANCIES AT INCREASED RISK OF PREECLAMPSIA: LONGITUDINAL BLOOD-PRESSURE TRAJECTORIES AND FIRST-TRIMESTER PLGF ASSOCIATIONS IN A REAL-WORLD COHORT
OANA-ELIZA CREȚU 1, MARINA-IONELA NEDEA 1*, ADRIAN-VALERIU NEACȘU 1,2, ADINA NENCIU 1,2, CRISTIAN-VIOREL POALELUNGI 1,2, IULIANA CEAUȘU 1,²
¹ University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
2 Clinical Hospital “Dr. Ion Cantacuzino”, Bucharest, Romania
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Preeclampsia remains a major cause of maternal and perinatal morbidity, and low-dose acetylsalicylic acid is the best-established pharmacological preventive intervention in high-risk pregnancies. This retrospective real-world cohort study evaluated evening aspirin 150 mg, blood-pressure trajectories, timing of preeclampsia, fetal growth restriction (FGR), and first-trimester placental growth factor (PlGF) in 42 pregnancies without chronic hypertension. Fourteen women (33.3%) received aspirin at 8 - 11 weeks. Preeclampsia occurred in 5/42 pregnancies (11.9%) and FGR in 14/42 (33.3%). Longitudinal models showed significant preeclampsia-status-by-time interactions for systolic and diastolic blood pressure, with divergence from 24 - 28 weeks onward. All preeclampsia cases occurred in women with first-trimester PlGF < 150 pg/mL (5/19), versus none with PlGF ≥ 150 pg/mL (p = 0.0137). Among documented cases, median gestational age at diagnosis was 28.5 weeks, suggesting delayed clinical expression. Findings support early, risk-stratified aspirin prophylaxis combined with longitudinal haemodynamic and placental-risk surveillance in routine clinical practice, using individualized first-trimester clinical and obstetric risk assessment.
