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Hypertensive Disorders of PregnancyPhase 4ASPIRINNCT06468202

Effectiveness of Two Aspirin Doses for Prevention of Hypertensive Disorders of Pregnancy: ASPIRIN TRIAL

A Phase 4 study testing Aspirin 81 mg and Aspirin 162 mg in people with Hypertensive Disorders of Pregnancy and Preeclampsia, run by Ohio State University at 20 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The overall goal of this large, pragmatic, comparative effectiveness trial is to test the hypothesis that among at-risk individuals, 162 mg/day aspirin is superior to 81 mg/day in preventing Hypertensive disorders of pregnancy (HDP), and that there are multiple factors associated with adherence with aspirin therapy… Read more about this study

Who is it for?
Ages 14 to 35 years, women only
What is being tested?
Aspirin 81 mg and Aspirin 162 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10,742 participants
Where
20 sitesUnited States
Study dates
18 Oct 2024to 1 Feb 2030
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 14 to 35 years
  • Women only
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • live intrauterine gestation ≤16 6/7 weeks gestational age based on best clinical obstetric estimate,
  • age 14 years or older and able to provide informed consent,
  • at least one of the following high-risk criteria: i) any prior pregnancy complicated by preeclampsia ii) current pregnancy complicated by chronic hypertension diagnosed before randomization (ACOG) iii) pre-gestational diabetes (on medication for diabetes prior to pregnancy, or diabetes is diagnosed prior to randomization with hemoglobin A1C of 6.5% or greater or abnormal 3-hour glucose tolerance test) iv) twin gestation (including higher order pregnancy reduced to twins prior to 14 weeks) v) chronic kidney disease vi) autoimmune disease (e.g., antiphospholipid syndrome, systemic lupus erythematous)
  • or two or more moderate-risk criteria for HDP (per USPSTF), i) nulliparity (no prior delivery at or after 20 weeks 0 days of gestation) ii) obesity (body mass index ≥30 kg/m2 at time of randomization) iii) age ≥35 years (at time of expected estimated due date) iv) Black race v) low income vi) personal risk factors (previous pregnancy with low birth weight or SGA infant, previous adverse pregnancy outcome [unexplained stillbirth], placental abruption, interval >10 years between pregnancies) vii) Family history of preeclampsia (i.e., mother or sister) viii) In vitro fertilization
  • patient not currently on aspirin OR patient on aspirin for obstetrical indications (e.g., related to IVF, or HDP) and: i- randomized before 130/7 weeks gestation, or ii- randomized on or after 13 0/7 weeks gestation and started aspirin within 2 weeks prior to randomization (e.g., aspirin started for HDP prevention at 12 0/7 weeks and patient randomized at 13 2/7 weeks).

Who cannot join

  • known allergy or hypersensitivity to aspirin or any medical condition where aspirin is contraindicated (e.g., active peptic ulcer disease, nasal polyps, NSAID-induced asthma, active gastrointestinal bleeding, known G6PD deficiency, severe hepatic dysfunction, bleeding disorders, history of bariatric surgery),
  • current or planned aspirin use in pregnancy for non-obstetrical indication (e.g., prior stroke/prior myocardial infraction),
  • age < 14 years,
  • involuntarily confined or detained,
  • considered as having a diminished decision-making capacity,
  • obstetrical ultrasound suspicious for major congenital abnormality, known or suspected fetal aneuploidy, fetal demise, or planned pregnancy termination,
Show all 11Show fewer
  • participation in another trial that affects the primary outcome, without prior approval of the PI,
  • plan to deliver at an outside participating site with inability to obtain medical records,
  • monoamniotic twin gestation because of the risk of fetal demise and preterm delivery,
  • participation in this trial in prior pregnancy,
  • triplet or higher order pregnancy.

Trial locations and contacts

20 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Maged Costantine, MD, MBA contact

614-293-2222

Maged.Costantine@osumc.edu

Kara Rood, MD contact

614-293-8045

Kara.Rood@osumc.edu

20 sites in 1 country

United States20 sites, 19 recruiting
  • University of New Mexico

    Albuquerque, New Mexico, 27710

    Christina Yarrington, MD, CYarrington@salud.unm.edu

    Karen S Taylor, kataylor@salud.unm.edu

    Recruiting
  • Austin Maternal Fetal Medicine

    Austin, Texas, 78758

    Mollie McDonnold, MS, 512-821-2540, mollie.mcdonnold@hcahealthcare.com

    Heather Azarmehr, MSN, RN, 737-415-6210, Heather.Azarmehr@stdavids.com

    Not yet recruiting
  • University of Alabama at Birmingham

    Birmingham, Alabama, 35233

    Akila Subramaniam, MD, MPH, asubramaniam@uabmc.edu

    Donna Campbell, PhD, 205-996-6268, dcampbell@uabmc.edu

    Recruiting
  • University of North Carolina, Chapel Hill

    Chapel Hill, North Carolina, 27514

    Kim Boggess, MD, kim_boggess@med.unc.edu

    Kelly Clark, Kelly_Clark@med.unc.edu

    Recruiting
  • Northwestern University

    Chicago, Illinois, 60611

    Michelle Kominiarek, MD, Michelle.Kominiarek@nm.org

    Catherine Arguelles, catherine.marek@nm.org

    Recruiting
  • The Ohio State University Wexner Medical Center OB/GYN Maternal and Fetal Medicine

    Columbus, Ohio, 43210

    Maged Costantine, MD, MBA, 614-293-2222, Maged.Costantine@osumc.edu

    Kara Rood, MD, 614-293-8045, Kara.Rood@osumc.edu

    Recruiting
  • Inova HealthSystem

    Falls Church, Virginia, 22042

    Antonio Saad, MD, Antonio.Saad@inova.org

    Michelle Cassidy, PhD, RN, 703-776-4600, Michelle.Cassidy@inova.org

    Recruiting
  • University of South Carolina Greenville

    Greenville, South Carolina, 29605

    Kacey Eichelberger, MD, kacey.eichelberger@prismahealth.org

    Patti Parker, BSN, RN, 864-455-1510, patti.parker@prismahealth.org

    Not yet recruiting
  • Baylor College of Medicine

    Houston, Texas, 77030

    Catherine Eppes, MD, 832-826-7376, Catherine.Eppes@bcm.edu

    Jia Chen, BSN, RN, MA, 832-826-7713, jiac@bcm.edu

    Not yet recruiting
  • University of Texas, Houston

    Houston, Texas, 77030

    Baha Sibai, MD, Baha.M.Sibai@uth.tmc.edu

    Sunbola Ashimi, PhD, Sunbola.S.Ashimi@uth.tmc.edu

    Recruiting
  • University of Mississippi

    Jackson, Mississippi, 39216

    Active, not recruiting
  • Cedars Sinai Medical Center

    Los Angeles, California, 90048

    Kimberly Gregory, MD, MPH

    Samia Saeb, Samia.Saeb@cshs.org

    Recruiting
  • Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

    Anna Palatnik, MD, apalatnik@mcw.edu

    Alyssa Hernandez, DO, 414-955-2781, alyhernandez@mcw.edu

    Recruiting
  • Ochsner Baptist Medical Center

    New Orleans, Louisiana, 70115

    Joseph Biggio, MD, MS, 504 842 5574, joseph.biggio@ochsner.org

    Nadrine Hayden, BS, 504- 897-5811, Nadrine.Hayden@Ochsner.Org

    Not yet recruiting
  • Columbia University

    New York, New York, 10032

    Matthew Hoffman, MD, (646) 284-5360, mh4795@cumc.columbia.edu

    Cassandra Almonte, ca2344@cumc.columbia.edu

    Recruiting
  • Eastern Virginia Medical School - Old Dominion University

    Norfolk, Virginia, 23501

    George Saade, MD, SaadeGR@EVMS.edu

    Kristin Ayers, ayerskl@evms.edu

    Recruiting
  • University of Pittsburg Magee

    Pittsburgh, Pennsylvania, 15213

    Hyagriv Simhan, MD, simhhn@upmc.edu

    Jeanette Boyce, tessje@upmc.edu

    Recruiting
  • Brown University

    Providence, Rhode Island, 02905

    William Grobman, MD, MBA, WGrobman@KentRI.org

    Angelica Demartino, (401) 274-1122 ext. 48521, AMDemartino@CareNE.org

    Recruiting
  • University of Utah

    Salt Lake City, Utah, 84132

    Ann Bruno, MD, Ann.Bruno@hsc.utah.edu

    Amber Sowles, BSN, RN, 801-585-5499, Amber.Sowles@hsc.utah.edu

    Recruiting
  • University of California, San Francisco

    San Francisco, California, 94158

    Mary Norton, MD, (415) 476-4080, Mary.Norton@ucsf.edu

    Nuriye Sahin-Hodoglugil, DrPH, nuriye.sahin-hodoglugil@ucsf.edu

    Recruiting

Other trials in United States

About this study

Official title: Comparative Effectiveness of Two Aspirin Doses for Prevention of Hypertensive Disorders of Pregnancy: ASPIRIN TRIAL

The overall goal of this large, pragmatic, comparative effectiveness trial is to test the hypothesis that among at-risk individuals, 162 mg/day aspirin is superior to 81 mg/day in preventing Hypertensive disorders of pregnancy (HDP), and that there are multiple factors associated with adherence with aspirin therapy that will be important to identify to enable optimal implementation of study findings and population-level benefits.

Read the detailed description

Hypertensive disorders of pregnancy (HDP), such as preeclampsia (PE) and gestational hypertension (gHTN), occur in ~15% of pregnant individuals, disproportionately affect self-identified non-Hispanic Black individuals (with the understanding that race is a socially defined construct and the inequity is related to social determinants of health), are increasing in frequency, and are associated with short- and long-term maternal and neonatal morbidities and mortality. There are currently no available therapeutics to treat individuals with HDP; thus, developing interventions for the prevention of HDP is of substantial public health significance. The U.S. Preventive Services Task Force (USPSTF) and other professional societies recommend or endorse the use of aspirin for prevention of HDP in individuals at high or moderate risk. However, there is great uncertainty regarding optimal dosing, whether there is heterogeneity of effectiveness of aspirin in reducing the risk of HDP among different populations, and what factors are associated with adherence.

The overall goal of this large, pragmatic, comparative effectiveness trial is to test the hypothesis that among at-risk individuals, 162 mg/day aspirin is superior to 81 mg/day in preventing HDP, and that there are multiple factors associated with adherence with aspirin therapy that will be important to identify to enable optimal implementation of study findings and population-level benefits. The trial will achieve the following specific aims:

Specific Aim 1: To compare the frequency of HDP (primary outcome), as well as other important secondary outcomes (gHTN, PE, preterm PE, PE-related adverse outcomes, aspirin-related safety outcomes, and patient-reported outcomes related to maternal health, pregnancy, and childbirth experiences) between the two aspirin treatment arms.

Specific Aim 2: To compare the gestational age at birth and the frequency of adverse perinatal outcomes (preterm birth, perinatal death, small-for-gestational-age birth, neonatal intensive care unit admission, and complications of prematurity), as well as patient-reported outcomes related to maternal-infant bonding between the two aspirin treatment arms.

Specific Aim 3: To use quantitative and qualitative analyses to elucidate facilitators and barriers associated with adherence to aspirin therapy in at-risk individuals during pregnancy in order to facilitate future implementation.

Being tested
Aspirin 81 mg, Aspirin 162 mg
Keywords
Hypertensive disorders of pregnancy, Aspirin treatment, Pregnancy, Preeclampsia
Medical subject headings
Pre-Eclampsia, Hypertension, Pregnancy-Induced

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aspirin 81 mgDrug

    Participants will be assigned to 81mg Aspirin

  • Aspirin 162 mgDrug

    Participants will be assigned to 162mg Aspirin

Study groups in NCT06468202
Study groupRoleWhat they receive
81 mg AspirinExperimentalTreatment A consisting of 81mg of aspirin (1 pill of 81mg \& 1 matching placebo) daily
Receives: Drug: Aspirin 81 mg
162 mg AspirinExperimentalTreatment B consisting of 162mg of aspirin (2 pills, each of 81mg) daily
Receives: Drug: Aspirin 162 mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hypertensive Disorder of Pregnancy (HDP)

    HDP defined as preeclampsia or antepartum gHTN based on ACOG criteria

    Measured: From >20 weeks gestation until hospital discharge following delivery, up to 22 weeks

Secondary outcomes (15)
  1. Preeclampsia

    preeclampsia based on ACOG criteria

    Measured: From >20 weeks gestation until hospital discharge following delivery, up to 22 weeks

  2. Preterm preeclampsia

    Preeclampsia per ACOG criteria with delivery < 37 weeks'

    Measured: From >20 weeks and ≤ 36 weeks 6 days, up to 17 weeks

  3. Postpartum preeclampsia

    Postpartum preeclampsia per ACOG criteria

    Measured: From delivery weeks till 6 weeks postpartum; 6 weeks

  4. Gestational hypertension

    Gestational hypertension per ACOG criteria

    Measured: From >20 weeks until onset of labor, up to 22 weeks

  5. Severe maternal morbidity

    Need for intensive care, maternal admission to a hospital within the first 42 days postpartum for obstetric complications, or blood product transfusion

    Measured: From randomization up to 6 weeks postpartum, up to 48 weeks

  6. Core preeclampsia outcomes

    Composite and individual maternal outcomes (Mortality, Eclampsia, Stroke, Cortical blindness, Retinal detachment, Pulmonary edema, Acute kidney injury, Liver capsule hematoma, Placental abruption, Postpartum hemorrhage, Elevated liver enzymes, Thrombocytopenia, ICU admission, Mechanical ventilation)

    Measured: From randomization up to 6 weeks postpartum, up to 48 weeks

  7. Bleeding complications (maternal)

    Antepartum bleeding and Placental abruption

    Measured: From randomization till delivery up to 36 weeks, up to 36 weeks

  8. Bleeding complications (maternal)

    Postpartum hemorrhage

    Measured: From delivery till hospital discharge, up to 1 week

  9. Adherence to aspirin

    pill count

    Measured: From randomization until last day of medication intake, up to 42 weeks

  10. Preterm birth

    Delivery <37 weeks

    Measured: At time of delivery

  11. Gestational age at birth

    Gestational age in weeks at time of delivery

    Measured: At time of delivery

  12. Core offspring/neonatal outcomes

    Composite and individual neonatal outcomes (Stillbirth, SGA, Neonatal mortality, Neonatal seizures, Admission to NICU, Respiratory support)

    Measured: up to 6 weeks post-delivery

  13. Rate of SGA

    Rate of birthweight <10th percentile

    Measured: At time of birth

  14. Bleeding complications (neonatal)

    Any neonatal intraventricular or intracranial hemorrhage

    Measured: Up to 6 weeks post-delivery

  15. Complications of prematurity and neonatal safety outcomes

    Composite of RDS, Grade III-IV IVH, PVL, Stage 2/3 NEC, BPD, Stage III or higher ROP, or early onset sepsis

    Measured: Up to 6 weeks post-delivery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jun 2024
  2. Study start18 Oct 2024
  3. Primary completion1 Jan 2029 (estimated)
  4. Study completion1 Feb 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
A randomized double-blind, multicenter, comparative effectiveness trial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
10,742 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06468202
Sponsor's protocol ID
Pro00079100
Acronym
ASPIRIN
Status last verified
Oct 2026
First submitted
12 Jun 2024
Last updated
27 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Aspirin 81 mg and Aspirin 162 mg in people with Hypertensive Disorders of Pregnancy and Preeclampsia, run by Ohio State University at 20 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 27 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Maged Costantine, MD, MBA (614-293-2222, Maged.Costantine@osumc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hypertensive Disorder of Pregnancy (HDP) (time frame: From >20 weeks gestation until hospital discharge following delivery, up to 22 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2026.

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