A Canadian randomized trial shows that tailored information improves understanding and supports preventive aspirin use during pregnancy
SOURCE: The Institute
October 20, 2025
A team led by Évelyne Vinet, MD, PhD, at the Research Institute of the McGill University Health Centre (The Institute) has completed the first randomized controlled trial of an educational tool designed for pregnant women with lupus (Systemic Lupus Erythematosus or SLE). The PREPARE study (Preeclampsia Education in Pregnancy for At-Risk Expectant mothers) found that the educational tool significantly improved participants' understanding of preeclampsia—a serious pregnancy complication that can endanger both mother and baby—and showed promising signs of better adherence to preventive low-dose aspirin. The findings, published in Rheumatology, highlight how tailored patient education can empower women and improve pregnancy outcomes in this high-risk population.
Women with lupus are at particularly high risk of preeclampsia because autoimmune inflammation can affect blood pressure, kidney function and placental health. Daily low-dose aspirin has been proven to reduce preeclampsia risk, but only when patients are aware of this preventive measure and take it consistently. The research team created the PREPARE tool, which adapts an existing educational resource with lupus-specific content and infographics, helping women recognize their risk and act on evidence-based prevention strategies to protect themselves and their babies.
In the multicentre trial, pregnant women with lupus were enrolled early in pregnancy and randomly assigned to receive either usual care or usual care plus the educational tool. Participants who were assigned the tool demonstrated greater gains in preeclampsia knowledge, and showed encouraging trends toward improved aspirin use. Recruiting participants was challenging given the rarity of lupus pregnancies, yet PREPARE remains one of the few randomized controlled trials ever conducted with this population.
"By empowering patients with evidence-based information, we can help optimize outcomes for SLE mothers and their babies," said Dr. Vinet, lead author of the study, Scientist in the Institute's Infectious Diseases and Immunity in Global Health Program and a member of the Centre for Outcomes Research and Evaluation.
In discussing the findings, the researchers noted that empowering patients with evidence-based information can help improve outcomes for both mothers with lupus and their babies. The PREPARE study demonstrates that even a simple, tailored educational tool can increase awareness and adherence to preventive measures, contributing to safer pregnancies in this high-risk population.
Looking Ahead
The research team will build on the PREPARE study using the LEGACY (Lupus in prEGnAnCY) cohort to evaluate wider implementation of the educational tool and its impact on aspirin use and pregnancy outcomes in women with lupus.
About the publication
The article "Randomized controlled trial of a lupus-specific educational tool to improve knowledge about preeclampsia and aspirin use" was authored by Joo-Young (Esther) Lee, Arielle Mendel, Isabelle Malhamé, Megan R W Barber, Ann E Clarke, Paul R Fortin, John G Hanly, Alexandra Legge, Christine Peschken, Carl A Laskin, Zahi Touma, Murray B Urowitz, Sasha Bernatsky and Évelyne Vinet.
The article was published in Rheumatology, the journal of the British Society for Rheumatology.
DOI: https://doi.org/10.1093/rheumatology/keaf334