APPLE: Aspirin to Prevent Pregnancy Loss and Preeclampsia

Inclusion Criteria

• •1. Provision of signed and dated informed consent form.
• •2. Stated willingness to comply with all study procedures and availability for the duration of the study.
• •3. Ability to take oral medication and be willing to adhere to the prescribed aspirin regimen.
• •4. Patients with a gestation less than or equal to 6 weeks, 6 days (as determined by patient record of LMP or ART date).
• •5. Patients between 18-45-year old who have one or more risk factors for preeclampsia and/or pregnancy loss, including:
• •1. preeclampsia in a previous pregnancy,
• •2. gestational diabetes in a previous pregnancy,
• •3. any documentation of fetal growth restriction or low birth weight in a prior pregnancy,
• •4. preterm birth in a previous pregnancy,
• •5. known multifetal gestation at enrollment,
• •6. chronic hypertension,
• •7. pregestational diabetes,
• •8. kidney disease,
• •9. systemic lupus erythematosus,
• •10. nulliparity,
• •11. pre-pregnancy body mass index \>30,
• •12. family history of preeclampsia (i.e., mother or sister),
• •13. Black persons (due to social, not biological reasons),
• •14. Maternal age 35 years or older,
• •15. lower income (will be determined by qualification of public health insurance),
• •16. conceived with fertility treatment (including in vitro fertilization, ovulation induction, or intrauterine insemination),
• •17. history of one or more prior pregnancy losses \<20 weeks gestation,
• •18. history of stillbirth in a prior pregnancy,
• •19. An interval of greater than 10 years since the last pregnancy.