Aspirin and pre-eclampsia: the heart of the matter?

Ling and colleagues (BJOG 2020 xxxx) have contributed important information on cardiovascular (CV) assessment over the course of pregnancy, with and without aspirin treatment, associated with risk of pre-term pre-eclampsia, as assessed by the multivariable competing risks model at 11-13 weeks. There are a number of important messages in these data. First, women at low- (vs. high-) risk of preterm pre-eclampsia appear to have lower cardiac output (CO), stroke volume (SV), and blood pressure (BP) in early pregnancy, consistent with the hypothesis that maternal CV predisposition plays a major role in pre-eclampsia risk (Ridder A et al. Int J Mol Sci. 2019;20(13)).