IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0200533.html
   My bibliography  Save this article

Effect of preconception low dose aspirin on pregnancy and live birth according to socioeconomic status: A secondary analysis of a randomized clinical trial

Author

Listed:
  • Shilpi Agrawala
  • Lindsey A Sjaarda
  • Ukpebo R Omosigho
  • Neil J Perkins
  • Robert M Silver
  • Sunni L Mumford
  • Matthew T Connell
  • Ashley I Naimi
  • Lisa M Halvorson
  • Enrique F Schisterman

Abstract

Low socioeconomic status (SES) is associated with adverse pregnancy outcomes and infertility. Low-dose aspirin (LDA) was shown to improve livebirth rates in certain subsets of women, and therefore, may impact pregnancy rates differentially by SES status. Therefore, the aim of the current study was to examine whether daily preconception-initiated LDA affects rates of pregnancy, livebirth, and pregnancy loss differently across strata of socioeconomic status (SES). This is a secondary analysis of The Effects of Aspirin in Gestation and Reproduction (EAGeR) Trial, a multisite, block- randomized, placebo-controlled trial conducted at four U.S. medical centers (n = 1,228, 2007–2012). Women attempting spontaneous conception with a history of pregnancy loss were randomly allocated preconception to 81mg of aspirin + 400mcg of folic acid (n = 615) or placebo + 400mcg of folic acid (n = 613). Study medication was administered for six menstrual cycles or until 36 weeks’ gestation if pregnancy was achieved. For this analysis, women were stratified by SES, which included income (low, mid, high) and a combined grouping of education and income (low-low, low-high, high-low, high-high). Log binomial models with robust variance estimated risks of pregnancy, livebirth, and pregnancy loss for LDA versus placebo. LDA increased pregnancy and livebirth rates (RR 1.23, 95% CI: 1.03, 1.45) in the high-income, but not mid- or low-income groups. LDA increased pregnancy rates in both the low education-low income group (RR 1.22, 95% CI: 1.02, 1.46) and the high education-high income group (RR 1.23, 95%CI: 1.06, 1.42), with no effect observed in mid-SES groupings. LDA, a low-cost and widely available treatment, may be particularly beneficial to women at the highest and lowest ends of the socioeconomic spectrum, though underlying mechanisms of this disparity are unclear. Confirming these findings and identifying factors which may modulate the effectiveness of LDA will ultimately facilitate personalized clinical care and improvements in population-level reproductive health.Trial registration number: ClinicalTrials.gov, NCT00467363.

Suggested Citation

  • Shilpi Agrawala & Lindsey A Sjaarda & Ukpebo R Omosigho & Neil J Perkins & Robert M Silver & Sunni L Mumford & Matthew T Connell & Ashley I Naimi & Lisa M Halvorson & Enrique F Schisterman, 2019. "Effect of preconception low dose aspirin on pregnancy and live birth according to socioeconomic status: A secondary analysis of a randomized clinical trial," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-14, April.
    • Handle: RePEc:plo:pone00:0200533
    DOI: 10.1371/journal.pone.0200533
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200533
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200533&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0200533?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Gelman, Andrew & Stern, Hal, 2006. "The Difference Between," The American Statistician, American Statistical Association, vol. 60, pages 328-331, November.
    2. Martinson, M.L. & Reichman, N.E., 2016. "Socioeconomic inequalities in low birth weight in the United States, the United Kingdom, Canada, and Australia," American Journal of Public Health, American Public Health Association, vol. 106(4), pages 748-754.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Colin F. Camerer & Anna Dreber & Felix Holzmeister & Teck-Hua Ho & Jürgen Huber & Magnus Johannesson & Michael Kirchler & Gideon Nave & Brian A. Nosek & Thomas Pfeiffer & Adam Altmejd & Nick Buttrick , 2018. "Evaluating the replicability of social science experiments in Nature and Science between 2010 and 2015," Nature Human Behaviour, Nature, vol. 2(9), pages 637-644, September.
    2. Lukas Haffert, 2019. "War mobilization or war destruction? The unequal rise of progressive taxation revisited," The Review of International Organizations, Springer, vol. 14(1), pages 59-82, March.
    3. Michael A. Allen & Michael E. Flynn & Julie VanDusky-Allen, 2017. "Regions of Hierarchy and Security: US Troop Deployments, Spatial Relations, and Defense Burdens," International Interactions, Taylor & Francis Journals, vol. 43(3), pages 397-423, May.
    4. David Spiegelhalter, 2017. "Trust in numbers," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 180(4), pages 948-965, October.
    5. Andrew P. Jaciw & Li Lin & Boya Ma, 2016. "An Empirical Study of Design Parameters for Assessing Differential Impacts for Students in Group Randomized Trials," Evaluation Review, , vol. 40(5), pages 410-443, October.
    6. Ignacio, Escañuela Romana, 2019. "The elasticities of passenger transport demand in the Northeast Corridor," Research in Transportation Economics, Elsevier, vol. 78(C).
    7. Gezahegn, Tafesse & Van Passel, Steven & Berhanu, Tekeste & D'Haese, Marijke & Maertens, Miet, 2020. "Structural and Institutional Heterogeneity among Agricultural Cooperatives in Ethiopia: Does it Matter for Farmers’ Welfare?," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, vol. 46(2), August.
    8. Charlene C. Nielsen & Carl G. Amrhein & Alvaro R. Osornio-Vargas, 2019. "Geographical Analysis of the Distribution of Publications Describing Spatial Associations among Outdoor Environmental Variables and Really Small Newborns in the USA and Canada," Challenges, MDPI, vol. 10(1), pages 1-29, January.
    9. Li, Xiaoyu & Kawachi, Ichiro & Buxton, Orfeu M. & Haneuse, Sebastien & Onnela, Jukka-Pekka, 2019. "Social network analysis of group position, popularity, and sleep behaviors among U.S. adolescents," Social Science & Medicine, Elsevier, vol. 232(C), pages 417-426.
    10. Marko Hofmann & Silja Meyer-Nieberg, 2018. "Time to dispense with the p-value in OR?," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 26(1), pages 193-214, March.
    11. Melisa Bubonya & Deborah A. Cobb-Clark & Daniel Christensen & Sarah E. Johnson & Stephen R. Zubrick, 2019. "The Great Recession and Children’s Mental Health in Australia," IJERPH, MDPI, vol. 16(4), pages 1-19, February.
    12. Thomas Ferguson & Hans-Joachim Voth, 2008. "Betting on Hitler—The Value of Political Connections in Nazi Germany," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(1), pages 101-137.
    13. Nikolova, Milena, 2018. "Self-Employment Can Be Good for Your Health," GLO Discussion Paper Series 226, Global Labor Organization (GLO).
    14. Simplice A. Asongu & Nicholas M. Odhiambo, 2020. "The role of governance in quality education in sub-Saharan Africa," Working Papers of the African Governance and Development Institute. 20/077, African Governance and Development Institute..
    15. Paolo Crosetto & Antonio Filippin, 2023. "Safe options and gender differences in risk attitudes," Journal of Risk and Uncertainty, Springer, vol. 66(1), pages 19-46, February.
    16. Arjen Witteloostuijn, 2020. "New-day statistical thinking: A bold proposal for a radical change in practices," Journal of International Business Studies, Palgrave Macmillan;Academy of International Business, vol. 51(2), pages 274-278, March.
    17. Zakharov, Nikita, 2019. "Does corruption hinder investment? Evidence from Russian regions," European Journal of Political Economy, Elsevier, vol. 56(C), pages 39-61.
    18. J. Sebastian Leguizamon & Casto Martin Montero Kuscevic, 2019. "Party Cues, Political Trends, And Fiscal Interactions In The United States," Contemporary Economic Policy, Western Economic Association International, vol. 37(4), pages 600-620, October.
    19. Hensel, Przemysław G., 2021. "Reproducibility and replicability crisis: How management compares to psychology and economics – A systematic review of literature," European Management Journal, Elsevier, vol. 39(5), pages 577-594.
    20. Brian Goesling, "undated". "Making Sense of Replication Studies: Guidance for Teen Pregnancy Prevention Researchers," Mathematica Policy Research Reports 02bb275446464c37a4fddbcdf, Mathematica Policy Research.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0200533. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.