Aspirin vs. placebo in twin pregnancies for preeclampsia prevention (ASPRE-T)

Preeclampsia (PE) is a medical condition that can happen during pregnancy after 20 weeks and it is characterised by high blood pressure and the presence of protein in the urine or in its absence the finding of maternal organ dysfunction. PE is one of the leading causes of maternal and perinatal death and disabilities. There is extensive evidence that in singleton high-risk pregnancies for PE, the use of aspirin (150mg / day from 12 until 36 weeks of gestation) reduces the chances of developing PE before 32 weeks by 89% and PE before 37 weeks by 62%. The rate of PE in twin pregnancies is about 9%, which is 3 –times higher than in singleton pregnancies. Few studies investigated the use of aspirin in reducing the risk of PE in twin pregnancies, but the results are inconsistent with the findings in singleton pregnancies. Therefore, the aim of this study is to determine whether taking low-dose aspirin can reduce the risk of PE in twin pregnancies.

Who can participate? Anyone pregnant with twins, aged > 18 years old that had a first trimester scan between 11+2 - 13+6 weeks of pregnancy at one of our recruiting hospitals.

What does the study involve?  To make sure this study is fair and with the highest quality standards, participants will be randomised to either Aspirin or placebo and will take 2 tablets per day, from 14+3 weeks until 36 weeks of pregnancy or delivery. There will be 3 telephone calls at 15+0- 16+6, 24+0-25+6  weeks and 30 days after last tablet intake and 4 follow-up visits that will happen at the same time as the regular scan appointments (about once per month).

The study involving 2,400 twin pregnancies will take place in 43 hospitals around the world (United Kingdom, Austria, Belgium, Bulgaria, Czech Republic, Denmark, Germany, Greece, Hungary, Ireland, Italy, Poland, Portugal, Spain, and also, Argentina, Australia, Brazil  and Israel). If you want to read more about the study ( or visit our webpage, and if you have any questions you can contact us at [email protected]

This study is funded by the Fetal Medicine Foundation, a Registered Charity that aims to improve the health of pregnant women and their babies through research and training in fetal medicine.