| Abstract: | Preeclampsia is an important cause of maternal and perinatal morbidity and mortality.Previous studies have tested calcium supplementation and aspirin separately to reducethe incidence of preeclampsia but not the effects of combined supplementation. Theobjective of this study was to investigate the effectiveness of aspirin combined withcalcium supplementation to prevent preeclampsia in women with chronic hypertension. Adouble-blind, placebo-controlled randomized clinical trial was carried out at theantenatal clinic of a large university hospital in São Paulo, SP, Brazil. A total of49 women with chronic hypertension and abnormal uterine artery Doppler at 20-27 weeksgestation were randomly assigned to receive placebo (N = 26) or 100 mg aspirin plus 2g calcium (N = 23) daily until delivery. The main outcome of this pilot study wasdevelopment of superimposed preeclampsia. Secondary outcomes were fetal growthrestriction and preterm birth. The rate of superimposed preeclampsia was 28.6% loweramong women receiving aspirin plus calcium than in the placebo group (52.2vs 73.1%, respectively, P=0.112). The rate of fetal growthrestriction was reduced by 80.8% in the supplemented group (25 vs4.8% in the placebo vs supplemented groups, respectively; P=0.073).The rate of preterm birth was 33.3% in both groups. The combined supplementation ofaspirin and calcium starting at 20-27 weeks of gestation produced a nonsignificantdecrease in the incidence of superimposed preeclampsia and fetal growth restrictionin hypertensive women with abnormal uterine artery Doppler. |
