Low-Dose Aspirin to Prevent Pregnancy-Induced Hypertensive Disease

To the Editor.  —"A Meta-analysis of Low-Dose Aspirin for Prevention of Pregnancy-Induced Hypertensive Disease," by Imperiale and Petrulis,¹ and "A Multivariate Analysis of Risk Factors for Preeclampsia," by Eskenazi et al,² add to the growing knowledge^3,4 of the potential to improve pregnancy outcome with daily low-dose aspirin starting in the second trimester. The meta-analysis combines studies for preventing pregnancy-induced hypertension with those for preventing recurrent fetal growth retardation. An additional recent study by Uzan et al⁵ provides more extensive data supporting prevention of fetal growth retardation with aspirin. Thus, thromboxane-induced placental insufficiency does not appear to be limited to pregnancies with hypertension.The published data suggest that pregnancy risk groups to be considered for low-dose aspirin include (1) primiparae, especially those who are black, and (2) women with (a) previous pre-eclampsia, (b) a history of previous fetal growth retardation not explained by other causes, and (c