Association between aspirin use during pregnancy and cardiovascular risk factors 2-7years after delivery: The nuMoM2b Heart Health Study.

Abstract

To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk. In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20+weeks, had data regarding aspirin use, and attended a study visit 2-7years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score. The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease. Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes. We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.