Trial Outcomes & Findings for Role of ASpirin in Placental and Maternal Endothelial Cell Regulation IN Pre-eclampsia (NCT NCT03893630)

NCT ID: NCT03893630

Last Updated: 2025-08-29

Results Overview

Uterine artery doppler is used to assess impedance to flow in the uterine artery three times: 11-16 weeks gestation(baseline), 18-22 weeks gestation (event 2), 28-32 weeks gestation (event 3). Data reported as change between 11-16 weeks gestation (baseline) and either 18-22 weeks gestation (event 2) or 28-32 weeks gestation (event 3). difference in uterine artery pulsatility index (PI) is calculated as the difference in PI for each patient between each trimester visit. PI at each visit will be calculated by averaging left-side and right-side PIs from each of three (or all available) images on each side for each patient using ultrasound technology. Unit of measure is a ratio: difference between the peak systolic and end-diastolic velocities divided by the mean flow velocity Relative change in uterine artery pulsatility index is a measure of flow to the uterus. A greater difference from the baseline value represents a greater improvement in placental perfusion.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

208 participants

Primary outcome timeframe

Three times between 11 and 32 weeks of gestation.

Results posted on

2025-08-29

Participant Flow

Participant milestones

Participant milestones
Measure
Control Group
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Overall Study
STARTED
65
68
75
Overall Study
COMPLETED
57
54
68
Overall Study
NOT COMPLETED
8
14
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Control Group
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Overall Study
Lost to Follow-up
5
4
2
Overall Study
Withdrawal by Subject
3
6
3
Overall Study
Discontinued Intervention
0
4
2

Baseline Characteristics

Role of ASpirin in Placental and Maternal Endothelial Cell Regulation IN Pre-eclampsia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control Group
n=65 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=68 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=75 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Total
n=208 Participants
Total of all reporting groups
Age, Continuous
29.5 years
STANDARD_DEVIATION 6.3 • n=39 Participants
29.6 years
STANDARD_DEVIATION 5.9 • n=41 Participants
29.8 years
STANDARD_DEVIATION 6.1 • n=35 Participants
29.7 years
STANDARD_DEVIATION 6 • n=31 Participants
Sex: Female, Male
Female
65 Participants
n=39 Participants
68 Participants
n=41 Participants
75 Participants
n=35 Participants
208 Participants
n=31 Participants
Sex: Female, Male
Male
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants
n=39 Participants
9 Participants
n=41 Participants
9 Participants
n=35 Participants
26 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
57 Participants
n=39 Participants
59 Participants
n=41 Participants
66 Participants
n=35 Participants
182 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=39 Participants
0 Participants
n=41 Participants
1 Participants
n=35 Participants
1 Participants
n=31 Participants
Race/Ethnicity, Customized
Asian
1 Participants
n=39 Participants
2 Participants
n=41 Participants
2 Participants
n=35 Participants
5 Participants
n=31 Participants
Race/Ethnicity, Customized
Black or African American
6 Participants
n=39 Participants
9 Participants
n=41 Participants
14 Participants
n=35 Participants
29 Participants
n=31 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants
n=39 Participants
0 Participants
n=41 Participants
1 Participants
n=35 Participants
2 Participants
n=31 Participants
Race/Ethnicity, Customized
White
49 Participants
n=39 Participants
52 Participants
n=41 Participants
45 Participants
n=35 Participants
146 Participants
n=31 Participants
Race/Ethnicity, Customized
More than one race
0 Participants
n=39 Participants
2 Participants
n=41 Participants
3 Participants
n=35 Participants
5 Participants
n=31 Participants
Race/Ethnicity, Customized
Hispanic
8 Participants
n=39 Participants
3 Participants
n=41 Participants
9 Participants
n=35 Participants
20 Participants
n=31 Participants
Region of Enrollment
United States
65 participants
n=39 Participants
68 participants
n=41 Participants
75 participants
n=35 Participants
208 participants
n=31 Participants
BMI at enrollment
29.2 kg/m2
STANDARD_DEVIATION 7.9 • n=39 Participants
35.7 kg/m2
STANDARD_DEVIATION 10.0 • n=41 Participants
34.1 kg/m2
STANDARD_DEVIATION 8.5 • n=35 Participants
33.1 kg/m2
STANDARD_DEVIATION 9.2 • n=31 Participants
Method of Conception
Natural
60 Participants
n=39 Participants
64 Participants
n=41 Participants
71 Participants
n=35 Participants
195 Participants
n=31 Participants
Method of Conception
Assisted by Ovulation Drugs
3 Participants
n=39 Participants
3 Participants
n=41 Participants
2 Participants
n=35 Participants
8 Participants
n=31 Participants
Method of Conception
In Vitro Fertilization
2 Participants
n=39 Participants
1 Participants
n=41 Participants
2 Participants
n=35 Participants
5 Participants
n=31 Participants

PRIMARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation.

Population: Participants delivered or lost to follow up not included

Uterine artery doppler is used to assess impedance to flow in the uterine artery three times: 11-16 weeks gestation(baseline), 18-22 weeks gestation (event 2), 28-32 weeks gestation (event 3). Data reported as change between 11-16 weeks gestation (baseline) and either 18-22 weeks gestation (event 2) or 28-32 weeks gestation (event 3). difference in uterine artery pulsatility index (PI) is calculated as the difference in PI for each patient between each trimester visit. PI at each visit will be calculated by averaging left-side and right-side PIs from each of three (or all available) images on each side for each patient using ultrasound technology. Unit of measure is a ratio: difference between the peak systolic and end-diastolic velocities divided by the mean flow velocity Relative change in uterine artery pulsatility index is a measure of flow to the uterus. A greater difference from the baseline value represents a greater improvement in placental perfusion.

Outcome measures

Outcome measures
Measure
Control Group
n=55 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=52 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=66 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Change in Pulsatility Index (PI)
Baseline to Event 2
-0.56 ratio
Standard Deviation 0.55
-0.53 ratio
Standard Deviation 0.34
-0.43 ratio
Standard Deviation 0.34
Change in Pulsatility Index (PI)
Baseline to Event 3
-0.88 ratio
Standard Deviation 0.56
-0.72 ratio
Standard Deviation 0.41
-0.58 ratio
Standard Deviation .54

SECONDARY outcome

Timeframe: From enrollment at 11 weeks throughout pregnancy and postpartum ( 6 weeks after delivery), approximately 35 weeks

Population: Participants delivered or lost to follow up not included

Frequency of Disease during pregnancy and postpartum as defined by American College of Obstetrics and Gynecology (ACOG) criteria

Outcome measures

Outcome measures
Measure
Control Group
n=58 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=61 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=73 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Onset of Pre-eclampsia
1 Participants
8 Participants
13 Participants

SECONDARY outcome

Timeframe: From enrollment at 11 weeks throughout pregnancy and immediate postpartum ( 6 weeks after delivery), approximately 35 weeks

Population: Participants delivered or lost to follow up not included

Frequency women are identified with Severe Features of the disease

Outcome measures

Outcome measures
Measure
Control Group
n=58 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=62 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=73 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Severity of Pre-eclampsia
0 Participants
0 Participants
0 Participants

SECONDARY outcome

Timeframe: Neonatal period ( first 28 days after birth)

Population: Participants lost to follow up not included

Frequency of adverse neonatal outcomes

Outcome measures

Outcome measures
Measure
Control Group
n=57 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=59 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=70 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Composite Neonatal Outcomes Including Frequency of Intraventricular Hemorrhage (IVH), Bronchopulmonary Dysplasia (BPD), Respiratory Distress Syndrome (RDS), Necrotising Enterocolitis(NEC)
5 Participants
17 Participants
21 Participants

SECONDARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation

Population: Serum specimens were not collected for all patients at individual timepoints related to issues such as patient refusal for venipuncture. Some elected to discontinue participation

Serial biologic samples will be obtained in the first (baseline), second (event 2), and third (event 3) trimesters to measure changes in soluble Intercellular Adhesion Molecule (s-ICAM) levels over time.

Outcome measures

Outcome measures
Measure
Control Group
n=57 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=53 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=64 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Change in s-ICAM Levels Over Time
Baseline and Event 2
6.1 ng/ml
Standard Deviation 12.6
1.6 ng/ml
Standard Deviation 30.8
7.9 ng/ml
Standard Deviation 28.5
Change in s-ICAM Levels Over Time
Baseline and Event 3
-29.6 ng/ml
Standard Deviation 15.0
-43.6 ng/ml
Standard Deviation 32.2
-34.1 ng/ml
Standard Deviation 25.5

SECONDARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation

Population: Serum specimens were not collected for all patients at individual timepoints related to issues such as patient refusal for venipuncture. Some elected to discontinue participation

Serial biologic samples will be obtained in the first (baseline), second (event 2), and third (event 3) trimesters to measure changes in placental growth factor (PIGF) levels over time.

Outcome measures

Outcome measures
Measure
Control Group
n=57 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=53 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=64 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Change in PIGF Levels Over Time
Baseline and Event 2
570.6 pg/ml
Standard Deviation 377.8
568.3 pg/ml
Standard Deviation 545.8
509.7 pg/ml
Standard Deviation 457.8
Change in PIGF Levels Over Time
Baseline and Event 3
-36.4 pg/ml
Standard Deviation 69.3
1.0 pg/ml
Standard Deviation 136.0
-16.7 pg/ml
Standard Deviation 44.1

SECONDARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation

Population: Serum specimens were not collected for all patients at individual timepoints related to issues such as patient refusal for venipuncture. Some elected to discontinue participation.

Serial biologic samples will be obtained in the first, second, and third trimesters to measure changes in C-reactive protein (CRP) levels over time.

Outcome measures

Outcome measures
Measure
Control Group
n=57 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=53 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=64 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Change in CRP Levels Over Time
Baseline and Follow Up 1
-0.5 mg/L
Standard Deviation 8.8
0.2 mg/L
Standard Deviation 9.3
-2.7 mg/L
Standard Deviation 8.8
Change in CRP Levels Over Time
Baseline and Delivery
-10.6 mg/L
Standard Deviation 11.9
-13.4 mg/L
Standard Deviation 12.4
-11.9 mg/L
Standard Deviation 13.2

SECONDARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation

Population: Not enough serum from samples to run these measures

Serial biologic samples will be obtained in the first, second, and third trimesters to measure changes in interleukin 6 (IL-6) levels over time.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Three times between 11 and 32 weeks of gestation

Population: Not enough serum from samples to run these measures

Serial biologic samples will be obtained in the first, second, and third trimesters to measure changes in tumor necrosis factor (TNFα) levels over time.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: At Delivery, up to 41 weeks

measured in weeks, from the first day of the last menstrual cycle to delivery

Outcome measures

Outcome measures
Measure
Control Group
n=65 Participants
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=68 Participants
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=75 Participants
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Gestational Age at Delivery
38.8 weeks
Standard Deviation 1.3
36.0 weeks
Standard Deviation 4.3
36.2 weeks
Standard Deviation 4.7

Adverse Events

Control Group

Serious events: 8 serious events
Other events: 3 other events
Deaths: 0 deaths

Acetylsalicylic Acid 81mg

Serious events: 12 serious events
Other events: 3 other events
Deaths: 0 deaths

Acetylsalicylic Acid 162mg

Serious events: 15 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Control Group
n=65 participants at risk
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=68 participants at risk
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=75 participants at risk
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Pregnancy, puerperium and perinatal conditions
Hemorrhage
12.3%
8/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
10.3%
7/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
12.0%
9/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Pregnancy, puerperium and perinatal conditions
Intrauterine Fetal Demise
0.00%
0/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
2.9%
2/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
1.3%
1/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Pregnancy, puerperium and perinatal conditions
Placental Abruption
0.00%
0/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
1.5%
1/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
2.7%
2/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Pregnancy, puerperium and perinatal conditions
Previable Delivery
0.00%
0/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
2.9%
2/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
4.0%
3/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery

Other adverse events

Other adverse events
Measure
Control Group
n=65 participants at risk
Patients will receive standard of care. Control: Standard of Care
Acetylsalicylic Acid 81mg
n=68 participants at risk
Patients will receive low dose (81mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 81 mg: Patients will receive 81mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Acetylsalicylic Acid 162mg
n=75 participants at risk
Patients will receive low dose (162mg) acetylsalicylic acid (Aspirin). Acetylsalicylic Acid 162 mg: Patients will receive 162mg acetylsalicylic acid daily, initiated between 11 and 16 weeks of gestation and continued until 36 weeks of gestation.
Nervous system disorders
headaches
3.1%
2/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
0.00%
0/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
0.00%
0/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Blood and lymphatic system disorders
Nose bleeds
0.00%
0/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
1.5%
1/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
0.00%
0/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Immune system disorders
Allergic reaction
0.00%
0/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
1.5%
1/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
0.00%
0/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery
Gastrointestinal disorders
Emesis
1.5%
1/65 • 29 weeks
Adverse Events were assessed from enrollment until delivery
1.5%
1/68 • 29 weeks
Adverse Events were assessed from enrollment until delivery
2.7%
2/75 • 29 weeks
Adverse Events were assessed from enrollment until delivery

Additional Information

Dr. John M. O'Brien

University of Kentucky

Phone: 8592575158

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place