Trial reportThe Journal of clinical investigation2015
Sex ratio following preconception low-dose aspirin in women with prior pregnancy loss.
Trial report in The Journal of clinical investigation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00467363 (The Effects of Aspirin in Gestation and Reproduction), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effects of Aspirin in Gestation and Reproduction: A Multi-center, Controlled, Double-blind Randomized Trial.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss.The Cochrane database of systematic reviews · 2020Pooled it
- Antiplatelet agents for preventing pre-eclampsia and its complications.The Cochrane database of systematic reviews · 2019Pooled it
- The Role of Maternal Preconception Adiposity in Human Offspring Sex and Sex Ratio.American journal of epidemiology · 2023Trial
- Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial.The Journal of clinical endocrinology and metabolism · 2017Trial
- Humoral pregnancy analyses reveal strategies for fetal protection and aberrancy in miscarriage.Cell reports. Medicine · 2026Article
- Preconception maternal body mass index and offspring sex ratio in intrauterine insemination cycles.Journal of assisted reproduction and genetics · 2026Article
- Chronic Inflammation Offers Hints About Viable Therapeutic Targets for Preeclampsia and Potentially Related Offspring Sequelae.International journal of molecular sciences · 2024Review
- Sex ratio shift after frozen single blastocyst transfer in relation to blastocyst morphology parameters.Scientific reports · 2024Article
- Infant sex at birth and long-term maternal mortality.Paediatric and perinatal epidemiology · 2023Article
- Serum C-reactive protein levels are associated with clinical pregnancy rate afterFrontiers in endocrinology · 2023Article
- Previous pregnancy loss and gestational cardiovascular health: A prospective cohort of nulliparous women.Frontiers in public health · 2023Article
- The role of maternal preconception vitamin D status in human offspring sex ratio.Nature communications · 2021Article
- Recurrent pregnancy loss.Nature reviews. Disease primers · 2020Review
- Article
- The role of aspirin and inflammation on reproduction: the EAGeR trialCanadian journal of physiology and pharmacology · 2019Review
- The Effects of Aspirin in Gestation and Reproduction (EAGeR) Trial: A Story of Discovery.Seminars in reproductive medicine · 2017Review
- Brief Report: Sex Ratio of Offspring Born to Women With Systemic Lupus Erythematosus or Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundSeveral lines of evidence suggest that male embryos may have greater vulnerability than female embryos to disordered inflammation; therefore, antiinflammatory drugs, such as low-dose aspirin (LDA), may alter the sex ratio. Here, we assessed the effect of LDA on male live birth and male offspring, incorporating pregnancy losses (n = 56) via genetic assessment, as part of a parallel-design, block-randomized, placebo-controlled trial of preconception LDA.
methodsParticipants (615 treated with LDA, 613 treated with placebo) ranged in age from 18 to 40 years of age, with 1 to 2 prior pregnancy losses. We estimated the intention-to-treat (ITT) risk ratio (RR) and 95% CI and assessed interaction with baseline high-sensitivity C-reactive protein (hsCRP) serum concentration - a marker of systemic inflammation.
resultsAmong the 1,078 women who completed follow-up (535 treated with LDA, 543 treated with placebo), the male live birth ITT RR equaled 1.31 (95% CI: 1.07-1.59). With increasing tertile of hsCRP, the proportion of males at birth decreased in the placebo group, and the effect of LDA on male live birth increased (first tertile: 48% male in LDA vs. 52% in placebo, ITT RR = 0.97, 95% CI: 0.70-1.35; second tertile: 57% male in LDA vs. 43% in placebo, ITT RR = 1.36, 95% CI: 0.98-1.90; third tertile: 53% male in LDA vs. 35% in placebo, ITT RR = 1.70, 95% CI: 1.13-2.57; P interaction = 0.03). Analysis of pregnancy with male offspring yielded similar results.
conclusionInitiation of LDA prior to conception restored numbers of male live births and pregnancy with male offspring among women with 1 to 2 prior pregnancy losses. Moreover, our data suggest that LDA modulates inflammation that would otherwise reduce the conception or survival of male embryos.
trial registrationClinicalTrials.gov NCT00467363.
fundingIntramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.