• Allison A Eubanks, Carrie J Nobles, Sunni L Mumford, Keewan Kim, Micah J Hill, Alan H Decherney, Lindsey A Sjaarda, Aijun Ye, Jeannie G Radoc, Neil J Perkins, Robert M Silver, and Enrique F Schisterman.
• Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
• Am J Perinatol. 2020 Oct 19.

Objective This study aimed to examine whether prenatal low-dose aspirin (LDA) therapy affects risk of cesarean versus vaginal delivery.Study Design This study is a secondary analysis of the randomized clinical effects of aspirin in gestation and reproduction (EAGeR) trial. Women received 81-mg daily aspirin or placebo from preconception to 36 weeks of gestation. Mode of delivery and obstetric complications were abstracted from records. Log-binomial regression models estimated relative risk (RR) of cesarean versus vaginal delivery. Data were analyzed among the total preconception cohort, as well as restricted to women who had a live birth.Results Among 1,228 women, 597 had a live birth. In the intent-to-treat analysis, preconception-initiated LDA was not associated with risk of cesarean (RR = 1.02; 95% confidence interval [CI]: 0.98-1.07) compared with placebo. Findings were similar in just women with a live birth and when accounting prior cesarean delivery and parity.Conclusion Preconception-initiated daily LDA was not associated with mode of delivery among women with one to two prior losses.Key Points· Aspirin was not associated with risk of cesarean section.. · Aspirin was not associated with mode of delivery.. · No increased risk of bleeding with use of aspirin..Thieme. All rights reserved.

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