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Poster Session 3

Category: Hypertension

Poster Session 3

(888) Antepartum Low Dose Aspirin Use and De Novo Postpartum Hypertension

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Natalie Cooley, BS

School of Medicine, University of California, Riverside
Riverside, California, United States

Coauthor(s)

NC

Natalie Creekmur, MD

Department of Obstetrics and Gynecology, Loma Linda University School of Medicine
Loma Linda, California, United States
SC

Sallie Canumay, DO, MSc

Department of Obstetrics and Gynecology, Riverside University Health System
Moreno Valley, California, United States
CG

Christopher Genobaga, MD

Department of Obstetrics and Gynecology, Riverside University Health System
Loma Linda, California, United States
LS

Leonard Soloniuk, MD

Department of Gynecology and Obstetrics, Riverside University Health System
Moreno Valley, California, United States
BO

Bryan Oshiro, MD

Department of Obstetrics and Gynecology, Riverside University Health System
Moreno Valley, CA, California, United States

Objective:
This study investigates whether antepartum low-dose aspirin (LDA) use in high-risk pregnancies reduces the incidence of de novo postpartum hypertension (dn-PPHTN) between 2 and 42 days postpartum.

Study Design:
We conducted a large scale retrospective cohort study using TriNetX, a U.S. collaborative network of 71 healthcare organizations and over 126 million patients. Patients aged 18 to 45 with a term uncomplicated delivery and at least one ACOG-defined high-risk factor for hypertensive disorders of pregnancy (HDP) were included. Patients with prior diagnoses of HDP or history of immunosuppressant use were excluded. Our study cohort consisted of patients prescribed 81 mg aspirin (ASA) at some instance within 189 days of delivery; the control cohort had no aspirin exposure during that time period. Propensity score matching (PSM) was used to balance age, race, ethnicity, and comorbidities between the cohorts. Outcomes were identified using ICD-10 codes related to postpartum hypertensive conditions during the 2–42 day postpartum period. Statistical analyses consisted of a 2-tailed T test and 95% confidence intervals with statistical significance defined as a p-value < 0.05.

Results:
After PSM, 2,304 patients remained in each cohort. The incidence of HTN without proteinuria shows a 0.006% lower risk (risk ratio [RR]= 0.46, p=0.028, CI 0.226,0.934) while pre-eclampsia shows a 0.008% lower risk (RR=0.62, p=0.039, CI 0.392,0.981) in the non-ASA cohort compared to the ASA cohort. There was no difference between cohorts in the risk ratio of unspecified maternal hypertension (HTN), elevated blood pressure (systolic >140 mmHg or diastolic >90 mmHg), essential HTN, acute kidney disease, eclampsia, and overall postpartum morbidity.

Conclusion:
These findings may suggest that antepartum LDA offers, at most, limited postpartum vascular protection in high-risk pregnancies without prior hypertension, as it may not be associated with reduced risk of dn-PPHTN. This warrants future investigation into the pathophysiology and prevention of dn-PPHTN beyond 48 hours postpartum.