Comparing aspirin and metformin for preventing preterm preeclampsia in high-risk pregnancies

Aspirin Versus Metformin in Pregnancies at High Risk of Preterm Preeclampsia: a 3-arm Randomized Controlled Trial

Not applicable Interventional Chinese University of Hong Kong · NCT05580523

This study is testing whether different doses of aspirin alone or with metformin can help prevent preterm preeclampsia in high-risk pregnant women.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment3000 (estimated)
Ages18 Years and up
SexFemale
SponsorChinese University of Hong Kong Academic / other
Locations6 sites (Beijing, Beijing and 5 other locations)
Trial IDNCT05580523 on ClinicalTrials.gov

What this trial studies

This clinical trial is a multicenter, randomized controlled trial that investigates the effectiveness of different doses of aspirin and the addition of metformin in preventing preterm preeclampsia among women identified as high-risk during their first trimester. Participants will be randomly assigned to one of three treatment arms: 75 mg of aspirin, 150 mg of aspirin, or 75 mg of aspirin combined with 1.5 g of metformin daily. The study aims to determine which intervention is most effective in reducing the incidence of preterm preeclampsia, with a focus on Chinese women. Screening for high-risk candidates will utilize a Bayes theorem-based method that incorporates maternal characteristics and medical history.

Who should consider this trial

Good fit: Ideal candidates for this study are women with singleton pregnancies who are at high risk for preterm preeclampsia as determined by specific screening criteria during their first trimester.

Not a fit: Patients who are under 18 years old, have multiple pregnancies, or have certain medical conditions such as bleeding disorders or serious mental illness may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a more effective prevention strategy for preterm preeclampsia, potentially improving outcomes for both mothers and infants.

How similar studies have performed: Other studies have shown promising results with aspirin in preventing preeclampsia, but the combination with metformin in this specific context is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Singleton pregnancies
* Live fetus at 11-13 weeks' gestation
* High-risk for preterm preeclampsia at 11-13 weeks by the algorithm combining maternal characteristics, medical and obstetric history, MAP and serum PlGF
* Informed and written consent

Exclusion Criteria:

* Age \<18 years old
* Multiple pregnancies
* Treatment with low-dose aspirin and metformin at the time of screening
* Pregnancies complicated by major fetal abnormality identified during the first trimester
* Women with learning difficulties, or serious mental illness
* Bleeding disorders such as Von Willebrand's disease
* Active peptic ulceration or gastrointestinal bleeding
* Hypersensitivity to aspirin, metformin hydrochloride and other biguanides
* Treatment with long term nonsteroidal anti-inflammatory medication
* Hyperemesis gravidarum
* Renal, liver or heart failure
* A serious medical condition
* Concurrent participation in another drug trial or at any time within the previous 28 days
* Any other reason the clinical investigators think will prevent the potential participant from complying with the trial protocol.

Where this trial is running

Beijing, Beijing and 5 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions PreeclampsiaPreterm preeclampsiaAspirinMetformin
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.