Antenatal Platelet Response on Aspirin: a Pharmacokinetic Study Through Pregnancy

Impact of Maternal Aspirin Tehrapy on the Maternal/Fetal Unit at Delivery: a Study of Aspirin Pharmacokinetics, Pharmacodynamics, and Pharmacogenomics Through Pregnancy

Longitudinal pharmacokinetic and pharmacodynamic study in first and third trimester of pregnancy

This will be a longitudinal addition to an existing R21cohort enrolled in the first trimester to include a first and third trimester assessment of pharmacokinetics/pharmacodynamics (PK/PD) of aspirin and how individual factors impact aspirin PK/PD in pregnancy.

Inclusion Criteria:

• <16 weeks' gestational age

• Singleton pregnancy

• Plan to take 81mg aspirin due to high risk history (below), but not yet initiated

• ≥1 risk factor:

  • Chronic hypertension

  • Type I or II diabetes

  • Previous preeclampsia

  • Renal disease

  • Autoimmune disease (SLE) OR

    ≥2 risk factor:

  • Nulliparity

  • IVF pregnancy

  • Black race or socioeconomic disadvantaged

  • BMI>30

  • Prior adverse pregnancy outcome

Exclusion Criteria:

• Contraindication to aspirin
• Current or planned use of any other anticoagulation
• Current need for dialysis
• Use of aspirin therapy prior to enrollment in the current pregnancy
• Thrombocytopenia (<150)
• Other known platelet disorder/thrombophilia at enrollment