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December 11, 1991

Low-Dose Aspirin to Prevent Pregnancy-Induced Hypertensive Disease-Reply

Author Affiliations

Case Western Reserve University Cleveland, Ohio

Case Western Reserve University Cleveland, Ohio

JAMA. 1991;266(22):3127-3128. doi:10.1001/jama.1991.03470220042017

In Reply.  —We appreciate the comments by Drs Clemenson and Bisonni regarding the potential cost savings of low-dose aspirin with respect to cesarean section. We agree with their concerns about the need to ascertain the indications for cesarean section and to study the effect of low-dose aspirin in greater numbers of subjects.The points made by Drs Rosa and Miwa are well stated. We concur with the need to examine the effect of low-dose aspirin in well-characterized patient subgroups. A more accurate and quantitative way of estimating risk is needed and should consider the variables that they mention. Unfortunately, because of the summary-level data contained in published studies, meta-analysis often cannot examine the effect of individual variables on outcome. This limitation may result in the failure to identify subgroups of patients that may respond differently to treatment than the overall results indicate.A careful reading of our article by Drs