Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Influence of aspirin on obstetric outcomes in women with pre-gestational diabetes: A South Western Sydney cohort study. (#99)

Andrew Jeyaruban 1 , Renuka Shanmugalingam 1 2 3 4 , Pamela Wu 1 , Rena Cao 1 , Vincent Wong 4 5 , Tang Wong 3 4 6 , Jeff Flack 3 4 6 , Angela Makris 1 2 3 4
  1. Department of Renal Medicine, Liverpool Hospital, SWSLHD, Liverpool, NSW, Australia
  2. Women’s Health Initiative Translational Research Unit (WHITU), Ingham Institute, SWSLHD, Sydney, NSW, Australia
  3. School of Medicine, Western Sydney University, Sydney, NSW, Australia
  4. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
  5. Department of Endocrinology, Liverpool Hospital SWSLHD, Sydney, NSW
  6. Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, SWSLHD, Sydney, NSW

 

 

Background

Women with pre-gestational diabetes mellitus (PGDM) are at an increased risk of preeclampsia. Initiation of prophylactic aspirin prior to 16 weeks of gestation in these women has been shown to reduce their risk of preeclampsia.  Our study, aimed to investigate the influence of prophylactic aspirin on obstetric outcomes in women with PGDM.

 

Method

A retrospective audit of data from pregnant women with PGDM from 2 centres in  South-Western Sydney from January 2005 to June 2020 was conducted. Data were obtained from a district wide electronic database, hospital medical records and partially prospectively collected data. The outcomes examined were preeclampsia, preterm delivery (less than 37 weeks) and newborn birth weight. Early preeclampsia was defined as less than 34 weeks and late pre-eclampsia was defined as 34 weeks or greater.   

 

Results:

Of 494 women, 124(25%) had Type 1 DM and  52(11%) women were prescribed prophylactic aspirin before 16 weeks of gestation. The dose of aspirin most commonly taken was 150mg (50%).Women who were prescribed aspirin before 16 weeks of gestation were more likely to be taking calcium but did not otherwise significantly differ compared to women not taking aspirin.  Preeclampsia overall developed in 57(12%) women and was early-onset preeclampsia in 24(5%) women. In the women prescribed aspirin, 8(15%) women developed preeclampsia compared to 49(11%) in those who were not prescribed aspirin(p=0.2). Aspirin use was not associated with a statistically significant difference in birth weight percentile (57vs 63, p=0.2). A higher number of preterm deliveries (21(41%) vs 97(23%) p<0.05) was observed in women who were prescribed aspirin. This was also observed post adjustment for age, primigravida and other comorbidities.

 

 

Conclusion.

This retrospective audit demonstrated a higher rate of preterm delivery in women with pre-gestational diabetes who were prescribed aspirin. There was no difference in the rate of preeclampsia and newborn birthweight.