Daily Aspirin May Help Prevent Some Recurrent Miscarriages

Miscarriage is an often unexpected and traumatic event for a woman and her partner. But new research suggests that something as simple as taking a daily low-dose aspirin could help prevent a recurrence.

The intervention appears to help boost live births in women with high levels of inflammation who previously lost a pregnancy, according to a research team from the U.S. National Institute of Child Health and Human Development (NICHD).

One obstetrician-gynecologist said the practice is already in use in cases involving women who've miscarried in the past.

"Doctors have often used baby aspirin in these patients to help achieve a healthy pregnancy," said Dr. Jennifer Wu, an ob/gyn at Lenox Hill Hospital in New York City who reviewed the new findings. "This study upholds a scientific theory to this treatment."

The research was led by Lindsey Sjaarda, a staff scientist at NICHD. Her team tracked outcomes for over 1,200 women, aged 18 to 40, with a prior pregnancy loss. All were trying to conceive, and a little more than half (55 percent) of the women went on to have a live birth.

The researchers tested the women for their blood levels of C-reactive protein (CRP), a substance in the blood that indicates systemwide inflammation, and which aspirin is thought to counteract.

The women were then randomly assigned to receive either daily low- dose aspirin (81 milligrams) or a placebo.

Among women with low or medium blood levels of CRP, Sjaarda's team found no significant difference in birth rates.

However, in the high-CRP group, the live-birth rate was 44 percent among women who only took the placebo (the lowest overall in the study) but 59 percent among those who took the daily aspirin, the findings showed. Aspirin also appeared to reduce CRP levels in the high-CRP group when those levels were checked at weeks 8, 20, and 36 of pregnancy. While the results are promising, further research is needed to confirm the findings and to learn more about how inflammation affects getting pregnant and maintaining a pregnancy, Sjaarda's group concluded.

Dr. Jill Rabin is co-chief of ambulatory care in women's health programs at Northwell Health in New Hyde Park, N.Y. She called the findings "provocative and interesting," but agreed that "additional research is needed to confirm the findings and to examine the potential influence of inflammation in becoming pregnant and maintaining pregnancy." For her part, Wu said that these types of interventions wouldn't be hard to implement in most clinics. "Testing for CRP is a simple blood draw and can easily be done for patients after one miscarriage," she explained. "This will provide guidance for the next pregnancy, which will hopefully result in a better outcome."

The study was published online Feb. 3 in the Journal of Clinical Endocrinology and Metabolism. SOURCES: Jennifer Wu, M.D., obstetrician-gynecologist, Lenox Hill Hospital, New York City; Jill Rabin, M.D., co-chief, division of ambulatory care, Women's Health Programs-PCAP Services, Northwell Health, New Hyde Park, N.Y.; Journal of Clinical Endocrinology and Metabolism, news release, Feb. 11, 2017

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