Association Between Aspirin Use During Pregnancy and Cardiovascular Risk Factors 2-7 years After Delivery: The NuMoM2b Heart Health Study

Overview

Journal Pregnancy Hypertens

Publisher Elsevier

Date 2022 Feb 14

PMID 35158155

Authors

Lauren H Theilen

Philip Greenland

Jasmina Varagic

Janet Catov

Anthony Shanks

Vanessa Thorsten

Corette B Parker

Rebecca McNeil

Brian Mercer

Matthew Hoffman

Ronald Wapner

David Haas

Hyagriv Simhan

William Grobman

Judith H Chung

Lisa D Levine

Shannon Barnes

Noel Bairey Merz

George Saade

Robert M Silver

Affiliations

Soon will be listed here.

Abstract

Objectives: To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk.

Study Design: In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20 + weeks, had data regarding aspirin use, and attended a study visit 2-7 years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7 years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score.

Main Outcome Measures: The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease.

Results: Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes.

Conclusion: We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7 years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.

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