Low-Dose Aspirin Prescription for Pregnant People at Risk for Preeclampsia [ID: 1356912

Abstract

INTRODUCTION: Low-dose aspirin (LDA) prescription during pregnancy is recommended for preeclampsia prevention for patients with one or more high-risk factors and two or more moderate-risk factors. Despite recognition that LDA is beneficial for at-risk patients, there appear to be gaps in the practice of prescribing LDA. Our objective was to measure prescriber adherence in a Midwestern health network. METHODS: A retrospective cohort analysis was performed using data from the electronic health records (EHRs) of a Midwestern health network. Patients who began prenatal care prior to 28 weeks and gave birth between September 2021 and December 2021 were included. Risk factors for preeclampsia and LDA prescription were extracted from the EHRs, with public insurance serving as a proxy for low socioeconomic status. Patients were excluded if LDA was contraindicated or prescribed for a purpose other than preeclampsia prevention. RESULTS: A total of 360 patients qualified for LDA recommendation during the study period. Of the 120 patients with at least one high-risk factor, 86 (71.7%) were prescribed LDA. Of the 240 patients with at least two moderate-risk factors, 54 (22.5%) were prescribed LDA. Among the 34 patients with a high-risk factor who were not prescribed LDA, the most common missed indication was autoimmune disease. Among the 186 patients with two or more moderate-risk factors who were not prescribed LDA, the most common risk factors included sociodemographic risk, nulliparity, and obesity. CONCLUSION: Our data demonstrate the need for quality improvement interventions targeting patients with two or more moderate-risk factors or the high-risk factor of autoimmune disease.