Preeclampsia still represents a life-threatening pregnancy complication, associated with severe maternal and neonatal morbidity and mortality. Low-dose Aspirin is advised to avoid preeclampsia in high-risk pregnancies worldwide. As Aspirin does not cover all women at risk, the prescription raises questions concerning optimal target population, dosage, and onset of therapy.

The aim of this study was to test platelet responsiveness on Aspirin by optical aggegrometry, to gain robust biochemically assessment data of Aspirin in an obstetric cohort. 248 women at high risk for development of preeclampsia were included in the study. Aspirin-prophylaxis was administered either in 100 mg (n = 229) or 150 mg (n = 90) daily. Dosing of 100 mg Aspirin was maintained if testing revealed a sufficient platelet inhibition. If platelet inhibition was insufficient, dosage was increased to 150 mg Aspirin and re-testing was advised. 91 patients (91/229 = 39.7%) presented a sufficient inhibitory Aspirin effect at a dosage of 100 mg, but in 138 patients LTA showed an inadequate Aspirin response (138/229 = 60.3%). In 19 women 150 mg Aspirin was administered as starting dose due to new recommendations. Of all women at 150 mg Aspirin 64 did not properly respond (35.4%). The overall rate of sufficient responding women regardless the Aspirin dose was 64.6%.

This study demonstrates still an insufficient inhibition of platelet aggregation in about 1/3 of women even with a dosage of 150 mg Aspirin daily, who might potentially benefit from further increase. These data show, that there is a need for further research to allow a personalized approach for individualized Aspirin therapy, maximizing the preventive benefit for mother and child.

先兆子痫仍然是一种危及生命的妊娠并发症，与严重的孕产妇和新生儿发病率和死亡率相关。建议低剂量阿司匹林在全球范围内避免高危妊娠发生先兆子痫。由于阿司匹林并未涵盖所有面临风险的女性，因此该处方引发了有关最佳目标人群、剂量和治疗开始的问题。

本研究的目的是通过光学聚集法测试血小板对阿司匹林的反应性，以获得产科队列中阿司匹林的可靠生化评估数据。该研究包括了 248 名处于先兆子痫高危风险的女性。每天服用 100 毫克（n = 229）或 150 毫克（n = 90）的阿司匹林预防剂。如果测试显示足够的血小板抑制，则维持 100 毫克阿司匹林的剂量。如果血小板抑制不足，剂量增加到 150 毫克阿司匹林，并建议重新测试。91 名患者 (91/229 = 39.7%) 在 100 mg 剂量下表现出足够的阿司匹林抑制作用，但在 138 名患者中，LTA 显示阿司匹林反应不足 (138/229 = 60.3%)。由于新的建议，19 名女性服用了 150 毫克阿司匹林作为起始剂量。在所有服用 150 毫克阿司匹林的女性中，有 64 人没有正确反应（35.4%）。无论阿司匹林剂量如何，充分反应女性的总体比率为 64.6%。

该研究表明，即使每天服用 150 毫克阿司匹林，仍有约 1/3 的女性对血小板聚集的抑制不足，这些女性可能会从进一步增加中获益。这些数据表明，需要进一步研究以允许个性化阿司匹林治疗的个性化方法，最大限度地为母亲和孩子提供预防益处。