DOI: https://doi.org/10.36347/sasjm.2026.v12i07.004

Pages: 722-728

Background: Preeclampsia, a hypertensive complication affecting 5–10% of pregnancies in Tunisia, remains a major cause of maternal and neonatal morbidity. Low-dose aspirin is a recommended preventive strategy but has been little studied locally. The aim of this study is to describe the effectiveness of treatment in at-risk women monitored at the Nabeul Regional Hospital. Methods: This was a prospective, descriptive observational study conducted between 2022 and 2024. Two hundred fifty patients with at least one risk factor for preeclampsia were included after providing informed consent. They received low-dose aspirin (75–150 mg/day) in accordance with international guidelines. Data were collected in real time during prenatal visits and at delivery. The primary endpoint was the incidence of preeclampsia; secondary endpoints included prematurity, birth weight, and the occurrence of aspirin-related adverse effects. The data were analyzed using SPSS 26. Results: Among the 250 patients included, the overall incidence of preeclampsia was 14%, including 10% mild cases and 4% severe cases, which was lower than the 20–25% reported in untreated women at risk. Initiation of aspirin before 16 weeks of amenorrhea was associated with a significant reduction in risk, with preeclampsia observed in 9% of patients compared to 27.1% for later initiation (OR = 3.12). Good treatment compliance also reduced the incidence of preeclampsia (11% vs. 26%; OR = 2.85). In multivariate analysis, chronic hypertension (OR = 2.98), history of preeclampsia (OR = 3.45), and nulliparity (OR = 2.15) were identified as independent predictors of preeclampsia despite prevention. Prematurity was observed in 20% of cases and birth weight below the 10th percentile in 16% of newborns, mainly in patients who developed severe preeclampsia. Hemorrhages, including postpartum hemorrhages, were reported in 6% of patients, 2% of which were potentially related to aspirin. Complications specific to preeclampsia were r