Prevalence of low-dose aspirin prophylaxis and its impact on maternal and fetal outcome in pre-eclamptic patients

Objective

To determine the prevalence of low-dose aspirin (LDA), missed opportunities in pre-eclampsia prevention and its impact on maternofetal outcomes among patients with pre-eclampsia.

Methods

A cross-sectional study of pre-eclampsia patients at the University of Benin Teaching Hospital, Benin City, Nigeria, prospectively recruited from February 1, 2023 to January 31, 2024. Data were collected using interviewer-administered questionnaires and medical records. Data were analyzed using SPSS 25.0. Chi-squared analysis and logistics regression were used and p-values <0.05 were considered significant.

Results

The mean age group of the 140 patients was 31.28 ± 6.29 years, of whom 17.9% used LDA and 52% were compliant. Missed opportunity for LDA use was 79.3% and was higher in high-parity women, those with a low level of education, unemployed women, unbooked patients, and in low levels of antenatal care (p < 0.049, p < 0.008, p < 0.001, and p < 0.001, respectively) and these were statistically significant. About 94.5% and 74.3% who had vaginal delivery and cesarean section, respectively, experienced missed opportunities for LDA use, results that were statistically significant (p < 0.022). The association between missed opportunities and materno-fetal complications (p > 0.604 and p > 0.318) were not significant. However, respondents who had missed opportunity LDA had higher odds of fetal complications (odds ratio 13.68, 95% confidence interval 2.50–74.91).

Conclusion

This study reveals underutilization and missed opportunities for LDA for pre-eclampsia prevention leading to adverse materno-fetal outcomes. There is a need to promote LDA use for the prevention of pre-eclampsia among clinicians, especially at peripheral healthcare institutions.