Evaluation of the Biological Response to Acetylsalicylic Acid by Platelet Occlusion Time in Pregnant Women in Brazzaville
LT Ocko Gokaba *
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo and Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
JA Elira Samba
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo.
OF Galiba Atipo-Tsiba
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo and Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
GRJ Buambo
Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
LO Ngolet
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo and Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
RC Iwandza
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo.
P Issongo Amboulou
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo.
J Nziengui Mboumba
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo.
C Bango
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo.
C Itoua
Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
A Elira Dokekias
National Reference Center for Sickle Cell Disease ''Antoinette SASSOU N'GUESSO'' Brazzaville, Congo and Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo.
*Author to whom correspondence should be addressed.
Abstract
Low-dose acetylsalicylic acid (ASA) has been recommended for pregnant women since 2011 by the OMS to prevent thrombotic phenomena. Despite the variability of its clinical efficacy (resistance phenomena), its non-standardized biological monitoring can be performed using platelet occlusion time (POT). The aim of this study was to assess the response to ASA using POT.
A multicenter, cross-sectional, analytical study was conducted in the obstetrics and gynaecology departments of six Brazzaville hospitals over a period of 09 months and included pregnant women on ASA 100 mg daily for at least 7 days. POT was measured using the INNOVANCE® PFA®-200 system. The variables studied were clinical (age, medical and obstetrical history) and biological (blood count, POT). Non-response to ASA was defined by a POT of 150 seconds or less. Data analysis was performed using STATA 12 software. Logistic regression was used to assess the determinants associated with non-response. The incidence of obstetric complications according to ASA resistance was evaluated by the Kaplan-Meier method and the Log-Rank test. The significance threshold was p<0.005.
The study involved 39 pregnant women, mean age 33.9 ± 5.4 years, treated with ASA for hypertensive disorders of pregnancy n=19 (48.7%), chronic arterial hypertension n=7 (18%), diabetes n=3(7.7%) fetal death n=3(7.7%), unexplained miscarriage n=3(7.7%), advanced age n=2 (5.1%) and twin pregnancy n=2(5.1%). The median body index was 25.5 kg/m2 [23.7;29.4] with 35.9% women of normal weight, 48.7% overweight and 15.4% obese. Non-response to ASA was found in 12 pregnant women (30.7%). No statistically significant differences were observed between non-responders and responders with regard to epidemiological, clinical and haematological determinants (p>0.05). Non-response was more observed in women with complications 23.08% versus 7.7% (p=0,008).
Non-response to ASA, present in a third of hypertensive pregnant women, is associated with the occurrence of obstetrical complications in Brazzaville.
Keywords: pregnancy, acetylsalicylic acid, PFA-200, biological response