Low-dose aspirin started in the first-trimester has been associated with a decrease of preeclampsia, fetal growth restriction and preterm birth in high-risk pregnancies. Multiple pregnancies are considered a risk factor for all those adverse outcomes. The main objective of the current trial is to evaluate whether a dose of 80 mg of aspirin is associated with an improvement of birthweight compared to placebo in twin pregnancies.
Twin pregnancies represent approximately 3% of births and are associated with increased risks of complications such as preeclampsia, fetal growth restriction and preterm birth. All of these complications are commonly associated impaired placental function and low birth weight. Most prophylactic measures tested over the years have failed to prevent these adverse outcomes in twin pregnancies. Since administration of low-dose of aspirin can improve placental function and all these adverse outcomes in high-risk pregnancies, mainly in women with prior adverse outcomes, we suggest that similar benefits could be seen in twins. We are expecting that the administration of low-dose of aspirin starting in the first-trimester in twin pregnancies could lead to an improvement of placental function, a reduction or these adverse perinatal outcomes and therefore to an improvement of birthweight.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
50
Capsule containing Acetylsalicylic Acid 80mg pill with lactose
Capsule containing placebo pill with lactose
Hôpital St-François d'Assise-CHUQ
Québec, Canada
Centre Hospitalier Universitaire de Québec (CHU de Québec)/Pavillon CHUL
Québec, Canada
Birth weight
Time frame: At delivery
Low birth weight
(birthweight below 2,500 grams)
Time frame: At delivery
Very low birth weight
(birthweight below 1,500 grams)
Time frame: At birth
Fetal growth restriction
(birthweight below the 10th or 3rd percentile for gestational age)
Time frame: 16-18 and 22-24 weeks
Preterm birth
(delivery before 37 weeks)
Time frame: At delivery
Very preterm birth
(delivery before 34 weeks)
Time frame: At delivery
Preeclampsia
(according to American College of Obstetricians and Gynecologists 2014 guidelines definition)
Time frame: At delivery
Early-onset preeclampsia
(onset of preeclampsia before 34 weeks)
Time frame: At delivery
UtA_PI
Mean uterine artery pulsatility index
Time frame: 22-24 weeks
Aspirin resistance
(PFA-100 below 150)
Time frame: 16-18 and 22-24 weeks
Cervical length
Time frame: 22-24 weeks
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