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  • 1
    Electronic Resource
    Electronic Resource
    Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives  To evaluate the risk of very preterm birth (22–32 weeks of gestation) associated with previous induced abortion according to the complications leading to very preterm delivery in singletons.Design  Multicentre, case-control study (the French EPIPAGE study).Setting  Regionally defined population of births in France.Sample  The sample consisted of 1943 very preterm live-born singletons (〈33 weeks of gestation), 276 moderate preterm live-born singletons (33–34 weeks) and 618 unmatched full-term controls (39–40 weeks).Methods  Data from the EPIPAGE study were analysed using polytomous logistic regression models to control for social and demographic characteristics, lifestyle habits during pregnancy and obstetric history. The main mechanisms of preterm delivery were classified as gestational hypertension, antepartum haemorrhage, fetal growth restriction, premature rupture of membranes, idiopathic preterm labor and other causes.Main outcome measures  Odds ratios for very preterm birth by gestational age and by pregnancy complications leading to preterm delivery associated with a history of induced abortion.Results  Women with a history of induced abortion were at higher risk of very preterm delivery than those with no such history (OR + 1.5, 95% CI 1.1–2.0); the risk was even higher for extremely preterm deliveries (〈28 weeks). The association between previous induced abortion and very preterm delivery varied according to the main complications leading to very preterm delivery. A history of induced abortion was associated with an increased risk of premature rupture of the membranes, antepartum haemorrhage (not in association with hypertension) and idiopathic spontaneous preterm labour that occur at very small gestational ages (〈28 weeks). Conversely, no association was found between induced abortion and very preterm delivery due to hypertension.Conclusion  Previous induced abortion was associated with an increased risk of very preterm delivery. The strength of the association increased with decreasing gestational age.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2004.00478.x
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  • 2
    Electronic Resource
    Electronic Resource
    Aspirin (100 mg) used for prevention of pre-eclampsia in nulliparous women: the Essai Régional Aspirine Mère–Enfant study (Part 1) (2003)
    Oxford, UK : Blackwell Science Ltd
    BJOG 110 (2003), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To reduce the incidence of pre-eclampsia in nulliparous women, in accordance with the suggestion of a recent meta-analysis that low dose aspirin might decrease this incidence by more than half if used early enough in and at a sufficient dose during pregnancy (more than 75 mg).Design Multicentre randomised double-blinded placebo-controlled trial.Setting Twenty eight centres in Northern of France and one in Belgium.Population Three thousand and two hundred ninety-four nulliparous women recruited between 14 and 20 weeks.Methods Randomisation to either 100 mg aspirin or placebo daily from inclusion through 34 weeks.Main outcome measures Preeclampsia was defined as hypertension (≥140 and or 90 mmHg) associated with proteinuria (≥0.5 g/L).Results The aspirin (n= 1644) and placebo (n= 1650) groups did not differ significantly in the mothers' incidence of pre-eclampsia (28 of 1632 [1.7%] vs 26 of 1637 [1.6%]; relative risk, RR, 1.08, 95% CI 0.64–1.83), hypertension, HELLP syndrome or placental abruption, or in the children's incidence of perinatal deaths or birthweight below the 10th centile. The incidence of babies with birthweight below the third centile was significantly higher in the aspirin group, with no explanation. The incidence of maternal side effects was higher in the aspirin group, principally because of a significantly higher rate of haemorrhage.Conclusions Aspirin at a dose of 100 mg does not reduce the incidence of pre-eclampsia in nulliparous women. Aspirin (100 mg) is associated with an increase in bleeding complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1471-0528.2003.02096.x
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  • 3
    Electronic Resource
    Electronic Resource
    Randomised comparison of uterine artery Doppler and aspirin (100 mg) with placebo in nulliparous women: the Essai Régional Aspirine Mère–Enfant study (Part 2) (2003)
    Oxford, UK : Blackwell Science Ltd
    BJOG 110 (2003), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To assess the effectiveness of a pre-eclampsia prevention strategy based on routine uterine artery Doppler flow velocity waveform examination during the second trimester of pregnancy, followed by a prescription for 100 mg aspirin in the case of abnormal Doppler findings.Design Multicentre randomised controlled trial.Setting Eleven centres in the north of France and one in Belgium.Population One thousand and eight hundred and fifty-three nulliparous women recruited between 14 and 20 weeks of gestation.Methods Randomisation either to undergo a uterine Doppler examination between 22 and 24 week of gestation or to take a placebo. Women with abnormal Doppler waveforms received 100 mg of aspirin daily from Doppler examination through 36 weeks.Main outcome measures Pre-eclampsia was defined as hypertension (≥ 140 and/or 90 mmHg) associated with proteinuria (≥ 0.5 g/L).Results One thousand two hundred and fifty-three women (67%) were randomised into the systematic Doppler group and 617 (33%) into the placebo group. Of the 1175 patients in the Doppler group who underwent this examination, 239 (20.3%) had abnormal uterine artery Doppler and received a prescription for aspirin. Despite the aspirin prescription, the frequency of pre-eclampsia did not differ between the systematic Doppler group and the placebo group (28 of 1237 [2.3%] vs 9 of 616 [1.5%]; RR = 1.55, 95% CI 0.7–3.3). Furthermore, the groups did not differ in the frequency of children who were very small for their gestational age (≤3rd centile) or for perinatal deaths. Compared with patients with normal Doppler findings, those with abnormal Doppler were at high risk of pre-eclampsia (RR = 5.5, 95% CI 2.5–12.2) and of giving birth to a small-for-gestational-age child (RR = 3.6, 95% CI 1.6–8.1).Conclusion Despite its sensitivity in screening for pre-eclampsia, routine uterine Doppler in the second trimester cannot be recommended for nulliparous patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1471-0528.2003.t01-1-02097.x
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    Paper (German National Licenses)
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