Evidence map›Paper›PMID 42002305›Full record

Trial reportBJOG : an international journal of obstetrics and gynaecology2026

Does Adherence Modify Low-Dose Aspirin Effects in Pregnancy? Post Hoc Analysis From a Multi-Centre Trial.

Musaku Mwenechanya, Abigail Mwapule Tembo, Elwyn Chomba, Matthew K Hoffman, Shivaprasad S Goudar, Janet L Moore, Mrityunjay C Metgud, Manjunath S Somannavar, Jean Okitawutshu, Adrien L Lokangaka and 24 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02409680 (Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT02409680 nacompletednot on this map

Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas (ASPIRIN)

TypeinterventionalSponsorNICHD Global Network for Women's and Children's HealthRan2016 to 2019Enrolled11,976ConditionsPremature BirthArmsLow dose aspirin, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Musaku MwenechanyaUniversity Teaching Hospital, Lusaka, Zambia.
Abigail Mwapule TemboUniversity Teaching Hospital, Lusaka, Zambia.
Elwyn ChombaUniversity Teaching Hospital, Lusaka, Zambia.
Matthew K HoffmanDepartment of Obstetrics and Gynecology, Christiana Care, Newark, Delaware, USA.
Shivaprasad S GoudarJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India.
Janet L MooreRTI International, Research Triangle Park, North Carolina, USA.
Mrityunjay C MetgudJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India.
Manjunath S SomannavarJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India.ORCID https://orcid.org/0000-0002-8871-5072
Jean OkitawutshuKinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Adrien L LokangakaKinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Antoinette K TshefuKinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Carl L BoseUniversity of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Melissa S BausermanUniversity of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Lester FigueroaInstituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala.
Ana GarcesInstituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala.
Nancy F KrebsUniversity of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Saleem JessaniAga Khan University, Karachi, Sindh, Pakistan.
Sarah SaleemAga Khan University, Karachi, Sindh, Pakistan.
Robert L GoldenbergColumbia University School of Medicine, New York, New York, USA.
Kunal KurheLata Medical Research Foundation, Nagpur, Maharashtra, India.
Prabir DasLata Medical Research Foundation, Nagpur, Maharashtra, India.
Archana B PatelLata Medical Research Foundation, Nagpur, Maharashtra, India.ORCID https://orcid.org/0000-0002-2558-7421
Patricia L HibberdBoston University School of Public Health, Boston, Massachusetts, USA.
Paul NyongesaMoi University School of Medicine, Eldoret, Kenya.
Fabian EsamaiMoi University School of Medicine, Eldoret, Kenya.
Sherri L BucherRichard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.
Norman GocoRTI International, Research Triangle Park, North Carolina, USA.
Jennifer J Hemingway-FodayRTI International, Research Triangle Park, North Carolina, USA.
Denise C BabineauRTI International, Research Triangle Park, North Carolina, USA.
Elizabeth M McClureRTI International, Research Triangle Park, North Carolina, USA.ORCID https://orcid.org/0000-0001-8659-5444
Robert M SilverUniversity of Utah, Salt Lake City, Utah, USA.
Richard J DermanSidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Waldemar A CarloUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0003-0382-9976
ASPIRIN Study Group Collaborators

Funding

Zika in Pregnancy Supplemental Funding requestU01HD040636 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI MCCLURE, ELIZABETH M · 2001 to 2017
$37.5M
Global Network for Women's and Children's Health Research Data Coordinating CenterU24HD092094 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI Elizabeth M McClure · 2017 to 2026
$17.8M
TJU-JNMC Global Network for Women's & Children's Health Research UnitUG1HD076457 · NICHD · THOMAS JEFFERSON UNIVERSITY · PI RICHARD J DERMAN · 2018 to 2026
$5.5M
Safe Pregnancy by Infectious Disease Control in KinshasaU01HD043475 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BOSE, CARL · 2003 to 2008
$5.2M
The Global Network and Preconception Maternal NutritionU10HD076474 · NICHD · UNIVERSITY OF COLORADO DENVER · PI HAMBIDGE, K MICHAEL, KREBS, NANCY F · 2013 to 2017
$5.1M
Global Network for Women's and Children's Health ResearchU10HD076461 · NICHD · INDIANA UNIVERSITY INDIANAPOLIS · PI LIECHTY, EDWARD A. · 2013 to 2017
$4.1M
CCHS-JNMC Global Network for Women's & Children's Health Research UnitU10HD076457 · NICHD · THOMAS JEFFERSON UNIVERSITY · PI DERMAN, RICHARD J · 2013 to 2017
$3.7M
Heart Rate Detection during Resuucitation to Reduce Early Neonatal MortalityU10HD078437 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CARLO FONT, WALDEMAR A. · 2013 to 2017
$3.3M
Columbia University/Aga Khan University Global Network Research UnitU10HD078438 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GOLDENBERG, ROBERT L · 2013 to 2017
$3.2M
Maternal and Child Health Benefits from Reducing Household Air PollutionU10HD078439 · NICHD · MASSACHUSETTS GENERAL HOSPITAL · PI HIBBERD, PATRICIA L · 2013 to 2017
$3.1M
Eunice Kennedy Shriver National Institute of Child Health and Human Development U01HD040636Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD043475Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD076457Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD076461Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD076474Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD078437Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD078438Eunice Kennedy Shriver National Institute of Child Health and Human Development U10HD078439NICHD NIH HHS U01 HD040636NICHD NIH HHS U01 HD043475NICHD NIH HHS U10 HD076457NICHD NIH HHS U10 HD076461NICHD NIH HHS U10 HD076474NICHD NIH HHS U10 HD078437NICHD NIH HHS U10 HD078438NICHD NIH HHS U10 HD078439NICHD NIH HHS U24 HD092094NICHD NIH HHS UG1 HD076457
6 · The paper itself

Abstract

objectiveTo evaluate if the effect of low-dose aspirin (LDA) commenced between 6 and 13 weeks of gestational age (GA) on preterm delivery (PTD) is modified by total exposure.

designPost hoc analysis of a randomized controlled trial.

settingHospitals in low-resource settings in Africa, Asia and Latin America. POPULATION: Outcomes were obtained for 11 908/11943 women at 6 0/7 to 13 6/7 weeks' GA randomized.

methodsWomen received prepackaged two-week medication allotments. Adherence was assessed by pill counts every 2 weeks. Estimated relative risk and 95% confidence interval data for each outcome at each GA of treatment initiation weeks were obtained by fitting a Poisson model to each outcome, adjusting for site, treatment arm and GA at treatment initiation. MAIN OUTCOMES MEASURES: The primary outcome was PTD. Secondary outcomes included PTD < 34 weeks and perinatal mortality including analysis by region.

resultsThe median gestational age at treatment initiation was 10.1 weeks (IQR 8.6, 12.0). 85.5% of the mothers had over 90% adherence to treatment. For each 1 week increase of GA at treatment initiation, the treatment risk ratio did not change for PTD [RR 0.97 (95% CI, 0.93, 1.02)], PTD < 34 weeks [< 0.98 (0.89, 1.07)] or perinatal mortality [1.04 (0.96, 1.12)], with no evidence of effect modification. For each 5% increase in adherence, the treatment risk ratio did not change for PTD [1.01 (0.99, 1.04)], PTD < 34 weeks [< 0.99 (0.95, 1.03)] or perinatal mortality [1.02 (0.98, 1.06)], indicating no meaningful interaction with adherence. There was no effect modification by region.

conclusionsThis analysis shows that the results of PTD, PTD < 34 weeks and perinatal mortality were not dependent on the timing of the initiation or adherence to treatment.

trial registrationClinicalTrials.gov identifier: NCT02409680.

Indexed as

AspirinDrug MonitoringPlatelet Aggregation InhibitorsPremature BirthAdultAfricaAsiaFemaleGestational AgeHumansInfant, NewbornLatin AmericaPerinatal MortalityPregnancyAspirinPlatelet Aggregation Inhibitorsaspirinnewborn infantperinatal mortalitypreeclampsiapregnancypremature birthpreterm infant

Identifiers

PMID42002305
PMCPMC13485436

What OpenQuestion holds

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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.