Current guidelines including those of the World Health Organization recommend low dose aspirin for all pregnant women with pregestational diabetes mellitus to reduce the risk of preeclampsia and small for gestational –age babies. A recent secondary meta-analysis of the maternal-fetal-medicine units’ high risk aspirin trial 1 found significantly higher rates of large for gestational age births in women with pregestational diabetes without microvascular complications, who had received aspirin prophylaxis compared to those randomised to placebo 2. In addition, aspirin prophylaxis was not found to reduce the number of small for gestational age neonates.
To determine whether low dose aspirin use in pregnancy is associated with an increased risk of large for gestational age infants in women with complicated and uncomplicated pregestational diabetes.
A retrospective study of 850 singleton pregnancies in women with pregestational diabetes (type 1 or type 2) delivering at King Edward Memorial Hospital between January 2013 to December 2017. Data was acquired from the midwives STORK database for demographics, ethnicity, parity, BMI, smoking history, pre-existing hypertension and birth weight. Individual patient notes were reviewed to determine duration of diabetes and associated complications, family history of hypertension, aspirin prophylaxis, HbA1c, pregnancy complications, celestone administration and birth complications. Birth centiles were calculated using the GROW calculator.
Statistical analysis will be performed to determine any association between aspirin prophylaxis and small or large for gestational age babies and incidence of preeclampsia in women with complicated and uncomplicated diabetes. This will include multivariate regression to account for potential confounders of birth centile including maternal BMI and level of maternal diabetic control.
Data and conclusions will be presented