CLASP: Aspirin For PET And IUGR Prevention Flashcards
What was the aim of the CLASP Trial?
To find out whether treatment with aspirin produces worthwhile effects on morbidity and on fetal and neonatal mortality, either overall or in selected subgroups of pregnancies judged to be at high risk of severe PET or IUGR.
To provide reliable evidence about the overall safety of LDA use in pregnancy
When, and it what journal was the CLASP trial published?
1994
Lancet
What was the setting of the CLASP Trial?
Multicentre, 16 countries
1988-1992
What was the study population of the CLASP Trial?
9364
What were the inclusion criteria for the CLASP Trial?
12-32/40
Prophylaxis of PET (74%)
Prophylaxis of IUGR (12%)
Treatment of PET (12%)
Treatment of IUGR (3%)
What were the exclusion criteria for the CLASP Trial?
Increased risk of bleeding
Allergy
High likelihood of immediate delivery
What were the two groups in the CLASP trial?
- 60mg aspirin daily
- placebo
Random allocation
Blinded
What were the outcome measures in the CLASP trial?
- Development of proteinuric PET
- Estimated duration of pregnancy
- BW <3rd centile for sex and GA
- Stillbirth or neonatal death ascribed to PET, maternal HTN, IUGR, maternal or neonatal bleeding, or from any cause
- Crude birthweight
How was PET diagnosed in the CLASP trial?
Increase in BP
- For those with DBP <90, needed to rise by 25mmHg
- For those with DBP >90, needed to rise by 15mmHg
Proteinuria: at least 1+ on dipstick, in absence of UTI
What was the reduction in the incidence of proteinuric PET with the use of aspirin?
Was it statistically significant?
12%
Not significant
The effect was greater for those that commenced aspirin <20/40
But the difference between this group and the group that commenced aspirin >20/40 was not significant
What was the effect of using aspirin on the incidence of IUGR, stillbirth and neonatal death in the CLASP Trial?
No significant effect
What was the conclusion of the CLASP Trial?
Our findings do NOT support routine prophylactic or therapeutic administration of anti platelet therapy in pregnancy to all women at increased risk of PET or IUGR.
