Recurrent miscarriage - an aspirin a day?

Recurrent miscarriage and later pregnancy complications are in some cases a ssociated with placental thrombosis and infarction, The aim of this study w as to assess the value of low dose aspirin (75 mg daily) in improving the s ubsequent livebirth rate amongst women with either unexplained recurrent ea rly miscarriage (<13 weeks gestation; n = 805) or unexplained late pregnanc y loss (n = 250), Amongst women with recurrent early miscarriages, there wa s no significant difference in the livebirth rate between those who took as pirin (251/367; 68.4%) compared with those who did not take aspirin [278/43 8; 63.5%; odds ratio (OR) 1.24; 95% confidence interval (CI) 0.93-1.67]. Th is relationship was independent of the number of previous early miscarriage s. In contrast, women with a previous late miscarriage who took aspirin had a significantly higher livebirth rate (122/189; 64.6%) compared with those who did not take aspirin (30/61; 49.2%: OR 1.88; 95% CI 1.04-3.37), The em pirical use of low dose aspirin amongst women with unexplained recurrent ea rly miscarriage is not justified. We are currently investigating the role o f incremental doses of aspirin in the treatment of women both with early mi scarriages associated with thrombophilic abnormalities and in those with la te pregnancy losses.