Early Administration of Low-Dose Aspirin for the Prevention of Preterm and Term Preeclampsia: A Systematic Review and Meta-Analysis

Abstract

Objective: To compare the effect of early administration of aspirin on the risk of preterm and term preeclampsia. Method: A systematic review and meta-analysis of randomized controlled trials were performed. Women who were randomized to low-dose aspirin or placebo/no treatment at or before 16 weeks of gestation were included. The outcomes of interest were preterm preeclampsia (delivery <37 weeks) and term preeclampsia. Pooled relative risks (RR) with their 95% confidence intervals (CI) were computed. Results: The search identified 7,941 citations but only five trials on a combined total of 556 women fulfilled the inclusion criteria. When compared to controls, aspirin initiated ≤16 weeks of gestation was associated with a major reduction of the risk of preterm preeclampsia (RR 0.11, 95% CI 0.04–0.33) but had no significant effect on term preeclampsia (RR 0.98, 95% CI 0.42–2.33). Conclusion: Low-dose aspirin administrated at or before 16 weeks of gestation reduces the risk of preterm but not term preeclampsia.

Metabolic profiles of placenta in preeclampsia using HR-MAS MRS metabolomics

“…139,140,168 Ma-67 ternal risk factor pro les di er between early onset preeclampsia and late onset preeclampsia, 168 and commonly cited factors (maternal MAP, UtAPI, PlGF and pregnancy associated plasma protein A (PAPP-A)) better predict the early onset disease. 168 Late onset preeclampsia is often referred to as the milder disease, but is in fact responsible for the majority of preeclampsia-related maternal deaths worldwide.…”

Pregnancy and menopause in patients with Systemic Lupus Erythematosus and/or Antiphospholipid Syndrome: practical guide from EULAR

“…57,58 However, all patients with positive titers should be stratified for the risk of maternal and fetal complications during pregnancy, and a combination therapy of low-dose aspirin and heparin should be considered.…”

Antiplatelet therapy before or after 16 weeks’ gestation for preventing preeclampsia

“…4 We previously observed that aspirin initiated before 16 weeks was beneficial to reduce the risk of preterm but not the term form of preeclampsia. 5 For the benefits of the readers and pregnant women, could the authors provide the relative risks of preterm preeclampsia (<37 weeks), early-onset preeclampsia (<34 weeks) and PTB (<37 weeks) associated with aspirin started at or before 16 weeks at a dose greater than 60 or 75 mg?…”