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IRELAND – Aspirin for Optimising Pregnancy Outcome in Pre-gestational Diabetes

Principal Investigator –Fionnuala Breathnach (Rotunda Maternity Hospital)

Pre-gestational diabetes represents a high-risk for the development of preeclampsia, with rates of preeclampsia within this group of approximately 20%. Women who have pre-gestational diabetes are at higher risk for pre-eclampsia and fetal growth restriction due to kidney damage associated with diabetes. The combination of diabetes and preeclampsia places the pregnancy at increased risk for stillbirth. Studies on the role of low-dose aspirin in the prevention of preeclampsia in high-risk women have yielded conflicting results.

Pre-eclampsia is caused by an imbalance between prostacyclin and thromboxane which are fat molecules in the body. This imbalance results from shallow placental invasion and restricted blood flow to body tissue (ischaemia) occurring shortly after implantation in the first trimester of pregnancy.

For this pilot study, 24 diabetic patients will be recruited at two hospitals (The Rotunda Hospital and The Coombe Women and Infants University Hospital). 12 patients were randomised to receive aspirin and 12 were controls (did not receive aspirin).

The aims of this study were to:

  • determine patient participation rates, compliance with taking aspirin and perinatal outcomes.
  • logistical issues relating to recruitment, data collection and procurement, transport and storage of serum samples will be tested in this pilot study.
  • develop a multi-centre study in a large group of diabetic patients.