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Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension.
- Source :
-
The New England journal of medicine [N Engl J Med] 1989 Aug 10; Vol. 321 (6), pp. 357-62. - Publication Year :
- 1989
-
Abstract
- There is evidence that aspirin in low doses favorably influences the course of pregnancy-induced hypertension, but the mechanism, although assumed to involve suppression of the production of thromboxane by platelets, has not been established. We performed a randomized study of the effect of the long-term daily administration of 60 mg of aspirin (n = 17) or placebo (n = 16) on platelet thromboxane A2 and vascular prostacyclin in women at risk for pregnancy-induced hypertension. Low doses of aspirin were associated with a longer pregnancy and increased weight of newborns. Serum levels of thromboxane B2, a stable product of thromboxane A2, were almost completely (greater than 90 percent) inhibited by low doses of aspirin. The urinary excretion of immunoreactive thromboxane B2 was significantly reduced without changes in the level of 6-keto-prostaglandin F1 alpha, a product of prostacyclin. Mass spectrometric analysis showed that aspirin reduced the excretion of the 2,3-dinor-thromboxane B2 metabolite--mainly of platelet origin--by 81 percent and of thromboxane B2, probably chiefly of renal origin, by 59 percent. The urinary excretion of 6-keto-prostaglandin F1 alpha and of its metabolite 2,3-dinor-6-keto-prostaglandin F1 alpha was not affected. Low doses of aspirin only partially (63 percent) reduced neonatal serum thromboxane B2. No hemorrhagic complications were observed in the newborns. Thus, in women at risk for pregnancy-induced hypertension, low doses of aspirin selectively suppressed maternal platelet thromboxane B2 while sparing vascular prostacyclin, but only partially suppressed neonatal platelet thromboxane B2, allowing hemostatic competence in the fetus and newborn.
- Subjects :
- 6-Ketoprostaglandin F1 alpha blood
Adult
Aspirin adverse effects
Aspirin therapeutic use
Epoprostenol biosynthesis
Female
Humans
Hypertension drug therapy
Hypertension metabolism
Pregnancy
Pregnancy Complications, Cardiovascular drug therapy
Pregnancy Complications, Cardiovascular metabolism
Random Allocation
Thromboxane A2 biosynthesis
Thromboxane B2 blood
Aspirin administration & dosage
Blood Platelets metabolism
Fetus metabolism
Hypertension blood
Pregnancy Complications, Cardiovascular blood
Thromboxanes biosynthesis
Subjects
Details
- Language :
- English
- ISSN :
- 0028-4793
- Volume :
- 321
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The New England journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 2664523
- Full Text :
- https://doi.org/10.1056/NEJM198908103210604