Estimating Aspirin resistance in high risk women (EARTH)
Research type
Research Study
Full title
Estimating Aspirin ResiTance in High-risk women (EARTH)
IRAS ID
135034
Contact name
Ana Alfirevic
Contact email
Sponsor organisation
University of Liverpool
Research summary
Pre-eclampsia is a multi-system disorder of pregnancy which adversely affects maternal endothelium and placental function. Aspirin reduces the risk of pre-eclampsia in high-risk women by 10%. Aspirin resistance could explain why a significant proportion of high-risk pregnant women develop pre-eclampsia despite treatment with low-dose aspirin.
The aim of this study is to define the proportion of women at high-risk of pre-eclampsia who are biochemically non-responsive to low dose aspirin, and assess if biochemical non-responsiveness is related to clinical outcomes. The study will also investigate genetic pathways involved in the mechanism of action and disposition of aspirin.
We will recruit a cohort of 100 high-risk pregnant women already taking low dose aspirin to assess the extent of aspirin-related platelet activation. The analysis will be done using two point of care tests, namely MultiplateTM and VerifyNowTM. Urine samples will also be collected to check compliance with aspirin using 11-Dehydrothromboxane B2. Third trimester placental function will be assessed with Placental Growth Factor 1 and obstetric ultrasound. We will also extract maternal DNA to explore genetic polymorphisms connected to platelet function.
The main outcome is biochemical non-responsiveness to aspirin and its relationship to key clinical outcomes (pre-eclampsia, fetal growth restriction, placental abruption and serious perinatal morbidity). Our long-term aim is to establish whether a personalised approach to preventative strategies for pre-eclampsia, based on aspirin-related platelet activation, will be a cost-effective way of reducing pre-eclampsia related maternal and neonatal morbidity
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
13/NW/0764
Date of REC Opinion
17 Dec 2013
REC opinion
Further Information Favourable Opinion