Which treatment has been shown to reduce risk for preterm birth, small for gestational age infants, and fetal or neonatal deaths?

• A. Low dose aspirin
• B. Antioxidant vitamins C & E
• C. Supplemental calcium
• D. Prenatal steroids

Answer: (A)

Low-dose aspirin reduces risk of placental vascular problems that drive preterm birth, small-for-gestational-age infants, and fetal or neonatal death. By giving a small, regular dose early in pregnancy to women at high risk for placental insufficiency, aspirin helps improve uteroplacental blood flow and lowers the chance of developing preeclampsia and related complications. When fewer severe placental problems occur, there are fewer preterm deliveries, fewer growth-restricted babies, and fewer fetal or neonatal deaths.

Antioxidant vitamins C and E have not shown benefit in preventing these outcomes, and calcium supplementation mainly reduces risk of preeclampsia in populations with low calcium intake but does not robustly prevent preterm birth or perinatal death across all groups. Prenatal steroids reduce neonatal complications after preterm birth but do not lower the risk of preterm birth itself.