BARBADOS LOW-DOSE ASPIRIN STUDY IN PREGNANCY (BLASP) - A RANDOMIZED TRIAL FOR THE PREVENTION OF PREECLAMPSIA AND ITS COMPLICATIONS

Objective To determine whether prophylactic, low dose controlled-relea se aspirin improves outcome for pregnant women and their babies in Bar bados. Design Randomised placebo-controlled trial. Setting The Queen E lizabeth Hospital, Barbados. Population All women attending antenatal clinics between 12 and 32 weeks of gestation were eligible, if without specific contraindications to aspirin and unlikely to deliver immedia tely. Methods Randomisation was computer-generated in the antenatal cl inic; 1822 women were allocated to receive 75 mg controlled-release as pirin and 1825 matching placebo. Main outcome measures Proteinuric pre -eclampsia, other pregnancy-induced hypertension, pregnancy duration, birthweight, stillbirths and neonatal deaths, major neonatal events. R esults All but three women from each group were followed up successful ly. Forty-four percent were primigravid, and 8% had previous obstetric complications. There were no significant differences between the allo cated treatment groups in the incidence of proteinuric pre-eclampsia ( 40 [2.2%] of those allocated aspirin, compared with 46 [2.5%] allocate d placebo), of preterm delivery (255 [14.0%] vs 270 [14.8%]), of birth weight < 1500 g (32 [1.7%] vs 33 [1.8%]) or of stillbirth and neonatal death (44 [2.4%] vs 38 [2.1%]). Aspirin was not associated with exces s risk of maternal or fetal bleeding. Conclusions The results of this study in Barbados do not support the routine use of low dose aspirin f or prevention of pre-eclampsia or its complications, confirming result s of previous large trials in other settings.