Effect of a small dose of aspirin on quantitative test of 24-h urinary protein in patients with hypertension in pregnancy

Abstract

The aim of the present study was to determine the effect of a small dose of aspirin on a quantitative test of 24-h urinary protein in patients with hypertension in pregnancy. In total, 224 patients with hypertension in pregnancy were continuously selected and were randomly divided into the control group (50 cases with conventional therapy), aspirin 50 mg/day group (60 cases), aspirin 75 mg/day group (58 cases), and aspirin 100 mg/day group (56 cases). Clinical effects were compared from 16 gestational weeks to childbirth. According to the comparison in the four groups, there was no statistical difference in the mean arterial pressure, pre-eclampsia rate, gestational weeks, and caesarean section rate (p>0.05). The 24-h urinary protein and endothelin-1 (ET-1) level were significantly decreased following treatment, and were less than the control and 50 mg/day groups. The superoxide dismutase (SOD) level was significantly increased, and higher than the control and 50 mg/day groups. In terms of the 75 and 100 mg/day, control and 50 mg/day groups, there was no statistical difference (p>0.05). A comparison of the complication rate in the four groups of fetuses during the perinatal period, no statistical difference was observed (p>0.05). Thus, the results show that, regarding patients with hypertension in pregnancy, 75 mg/day aspirin can decrease the 24-h urinary protein, SOD, and ET-1 level. However, the results remain to be confirmed to improve maternal and infant outcome in delivery.

Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

“…Four studies reported as an outcome, emergency CS for intrapartum fetal distress, of which three showed a non‐significant increase in risk, and one demonstrated a non‐significant risk reduction in women taking LDA. Birth asphyxia/acidosis was reported in five studies, however, in one study it was defined as either cord artery pH < 7.15 or base excess < −7 mmol/L or 5‐min Apgar score < 6, in another as base excess > 90 th centile (12 mEq/L) and in a third as cord pH < 7.15, while it was not defined in the other two studies. Three of the studies showed a non‐significant increase whilst the remaining two showed a non‐significant reduction in the risk of birth asphyxia/acidosis in women receiving LDA.…”

“…Five studies in which LDA was started ≤ 16 weeks' gestation reported placental abruption as an outcome. The meta‐analysis demonstrated that LDA was not associated with an increased risk of placental abruption (RR, 0.68; 95% CI, 0.40–1.15; P = 0.15) and this effect was independent of the aspirin dose used.…”

“…Following review of the abstracts, 119 potentially suitable trials were selected for full review. Of these, 40 studies involving 34 807 participants, met the inclusion criteria and were included in the final analysis (Figure ).…”

“…Assessment of bias revealed that 21 (52.5%) studies were at low risk of bias (Figure S1). Nine (22.5%) studies had a high risk in one or more domains, predominantly due to lack of blinding (no placebo treatment in the control arm) or due to an inadequate method of treatment allocation/concealment. These studies were still included in the final analysis and sensitivity assessment was performed to assess the impact of bias on the outcomes.…”

“…None of the included studies reported on intrapartum fetal distress as an outcome. Due to the limited number of studies reporting the outcomes of operative vaginal birth, emergency CS for intrapartum fetal distress and birth asphyxia, these outcomes were not included in the meta‐analysis, and the individual study findings from the 10 studies reporting on these outcomes are presented in Table S1. Three studies reported on operative‐vaginal‐delivery rate, with all showing a reduced, albeit non‐significant, risk among women taking LDA.…”