Materials and Methods: A total of 140 women were included, comprising 75 in the IUGR surveillance cohort and 65 in the PET cohort. Adherence was assessed across three domains: initiation before 16 weeks, use of the recommended 75–150 mg dose, and continuation until at least 36 weeks or delivery. Maternal and neonatal outcomes included recurrent IUGR, development of PET, neonatal intensive care unit (NICU) admission, birthweight, and gestational age. Statistical analysis included descriptive summaries, chi-square tests, and Welch’s t-tests.

Results: Adherence to the recommended dose was universal (100%) across both cohorts, but initiation (77% in IUGR, 83% in PET) and duration adherence (75% in IUGR, 63% in PET) were less consistent, resulting in overall adherence rates of 59% and 52%, respectively. Recurrent IUGR occurred in 21% of the IUGR cohort, while PET developed in 19% of the PET group. NICU admission was more frequent in the PET cohort (29%) compared with the IUGR group (20%). Importantly, adherence was associated with higher birthweight in the IUGR cohort (2959 g vs 2713 g, P = 0.041), although the observed difference was modest, and no significant effect was observed on gestational age or PET outcomes.

Conclusions: These findings highlight that while aspirin prophylaxis is widely adopted, persistence remains suboptimal, particularly with respect to duration adherence.