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The ASPRE trial tested nightly low-dose aspirin in women identified by first-trimester screening as being at high risk of preterm preeclampsia. Aspirin started early in pregnancy reduced the incidence of preterm preeclampsia compared with placebo. The study is important because it demonstrates the value of combining risk prediction with an inexpensive preventive intervention. For clinicians, the key challenge is identifying the appropriate high-risk population and initiating aspirin at the correct gestational window rather than using it indiscriminately. The trial also highlights how first-trimester maternal characteristics and biophysical or biochemical markers can support risk stratification. Aspirin is not a substitute for surveillance, management of chronic hypertension or treatment of established preeclampsia. Its role is preventive, and adherence matters. The study is particularly relevant to high-risk obstetric pathways that aim to move from reactive treatment of severe disease toward earlier prevention.
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The ASPRE trial tested nightly low-dose aspirin in women identified by first-trimester screening as being at high risk of preterm preeclampsia. Aspirin started early in pregnancy reduced the incidence of preterm preeclampsia compared with placebo. The study is important because it demonstrates the value of combining risk prediction with an inexpensive preventive intervention. For clinicians, the key challenge is identifying the appropriate high-risk population and initiating aspirin at the correct gestational window rather than using it indiscriminately. The trial also highlights how first-trimester maternal characteristics and biophysical or biochemical markers can support risk stratification. Aspirin is not a substitute for surveillance, management of chronic hypertension or treatment of established preeclampsia. Its role is preventive, and adherence matters. The study is particularly relevant to high-risk obstetric pathways that aim to move from reactive treatment of severe disease toward earlier prevention.
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