Wright D, et al. - The authors designed this study to determine the effect of prophylactic use of aspirin during pregnancy in women at high-risk of preeclampsia on length of stay in the Neonatal Intensive Care Unit. They observed that administration of aspirin in pregnancies at high-risk of preeclampsia resulted in a reduction of the length of stay in the Neonatal Intensive Care Unit by about 70%. This reduction could necessarily be associated with a decline in the rate of births at <32 weeks’ gestation, mainly because of prevention of early preeclampsia. The findings were observed to have implications for both short- and long-term healthcare costs as well as infant survival and handicap.

Methods

• Researchers performed a secondary analysis of data from the Aspirin for Evidence-Based Preeclampsia Prevention trial to assess evidence of differences in the effect of aspirin on length of stay in neonatal intensive care.
• The comparison of mean length of stay between the aspirin and placebo groups was performed using Bootstrapping.
• Treatment effects on stay in the Neonatal Intensive Care Unit were assessed using logistic-regression.

Results

• One thousand six hundred and twenty (1,620) participants were there in this trial and 1,571 neonates were liveborn.
• The placebo vs aspirin group showed substantially longer total length of stay in neonatal intensive care(1696 vs 531 days).
• Finding thus suggested markedly shorter mean lengths of stay for babies admitted to the Neonatal Intensive Care Unit from the aspirin than the placebo group (11.1 vs 31.4 days; a reduction of 20.3 days (95% confidence interval, 7.0-38.6; p=0.008).
• Across both treatment arms, neonatal intensive care of babies born at <32 weeks’ gestation contributed 1,856 (83.3%) of the total of 2,227 days in intensive care.
• Researchers observed these occurrences in 9 (1.2%) of the 777 livebirths in the aspirin group and in 23 (2.9%) of 794 in the placebo group (odds ratio 0.42; 95% confidence interval, 0.19-0.93; p=0.033).
• Overall, the mean length of stay was longer in the placebo than aspirin group in the whole population (2.06 vs 0.66 days; reduction of 1.4 days (95% confidence interval, 0.45-2.81; p=0.014); this included zero lengths of stay for those that were not admitted to the Neonatal Intensive Care Unit.
• This corresponded to a reduction of 68% in length of stay (95% confidence interval, 20-86%).