Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force

Henderson, Jillian T.; Whitlock, Evelyn P; O’Connor, Elizabeth; Senger, Caitlyn A; Thompson, Jamie H; Rowland, Maya G

doi:10.7326/m13-2844

Cited by 428 publications

(396 citation statements)

References 72 publications

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“…W pierwszym i drugim trymestrze można rozważyć leczenie klasycznymi lekami z grupy NSAID (ibuprofen, indometacyna) [25][26][27]. Większość ekspertów preferuje duże dawki ASA, które stosuje się rutynowo w leczeniu zespołu antyfosfolipidowego u kobiet w ciąży i jest także umiarkowanie skuteczne w zapobieganiu rozwojowi stanu przedrzucawkowego u pacjentek obarczonych czynnikami ryzyka [224,225]. Po upływie 20. tygodnia ciąży podanie jakichkolwiek NSAID (z wyjątkiem ASA w dawce ≤ 100 mg/d.)…”

Section: Ciąża Okres Karmienia Piersiąunclassified

“…może powodować zamknięcie przewodu tętniczego i wywołać upośledzenie czynności nerek płodu. Leki te powinno się bezwzględnie wycofać w 32. tygodniu ciąży [224,225]. Podczas całego okresu ciąży i karmienia piersią można podawać najmniejszą skuteczną dawkę prednizonu, stosując jednocześnie suplementację wapnia i witaminy D [25][26][27].…”

Section: Ciąża Okres Karmienia Piersiąunclassified

See 1 more Smart Citation

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Adler

Charron²,

Imazio³

et al. 2015

Kardiol Pol

192

293

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Section: Ciąża Okres Karmienia Piersiąunclassified

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Adler

Charron²,

Imazio³

et al. 2015

Kardiol Pol

192

293

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“…27 Full implementation of this intervention among all at-risk women could yield a 0.21-point reduction in the overall PTB rate (Fig 1). Other risk factors, specifically inadequate interpregnancy interval 28 and teen pregnancy, 29 have been shown to contribute to prematurity in the United States, although evidence-based interventions have not been proven and modeled for effect size.…”

Section: Reduction Of Early Elective Deliveries and Impact On Ptbmentioning

confidence: 99%

Fighting for the Next Generation: US Prematurity in 2030

et al. 2014

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Preterm birth (PTB) is a serious problem, with >450 000 neonates born prematurely in the United States every year. Beginning in 1980, the United States experienced a nearly 3-decade rise in the PTB rate, peaking in 2006 at 12.8%. PTB has declined for 7 consecutive years to 11.4% in 2013, but it still accounts for 1 in 9 neonates born every year. In addition to elevated neonatal and infant mortality among those born preterm, many who survive will have lifelong morbidities and disabilities. Because of the burden of morbidity, disability, and mortality for PTB, as well as its impact more broadly on society, including excess annual costs estimated to be at least $26.2 billion by a committee for the Institute of Medicine, the March of Dimes initiated the Prematurity Campaign in 2003. In 2008 the March of Dimes established a goal of reducing the US PTB rate to 9.6% by 2020. However, the United States ranks extremely poorly for PTB rates among Very High Human Development Index (VHHDI) countries, subjecting untold numbers of neonates to unnecessary morbidity and mortality. Therefore, the March of Dimes proposes an aspirational goal of 5.5% for the 2030 US PTB rate, which would put the United States in the top 4 (10%) of 39 VHHDI countries. This 5.5% PTB rate is being achieved in VHHDI countries and by women from diverse settings receiving optimal care. This goal can be reached and will ensure a better start in life for many more neonates in the next generation.

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“…A very recent systemic review observed clinically important and statistically significant reductions in several important outcomes, but the investigators stated that their confidence was tempered by potential small-study effects and observed modest effects on outcomes in the 2 largest trials. 23 Depending on baseline risk, aspirin use was associated with absolute risk reductions of 2% to 5% for preeclampsia (RR ϭ 0.76; 95% CI ϭ 0.62-0.95), 1%-5% for intrauterine growth restriction (RR ϭ 0.80; 95% CI ϭ 0.65-0.99), and 2%-4% for preterm birth (RR ϭ 0.86; 95% CI ϭ 0.76 -0.98). The investigators did not observe different effects in trials in which aspirin was started before 16 weeks gestational age.…”

Section: Aspirin To Prevent Preeclampsiamentioning

confidence: 99%

Anticoagulation in pregnancy complications

Middeldorp

2014

Hematology

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Women with acquired and inherited thrombophilia are thought to be at increased risk for pregnancy complications, including recurrent pregnancy loss and, depending on the type of thrombophilia, severe preeclampsia. This review discusses the associations between the types of thrombophilia and types of complications, as well as the currently available clinical trial evidence regarding the use of aspirin and heparin to prevent these pregnancy complications. In women with antiphospholipid syndrome, guidelines recommend prescribing aspirin and heparin to women with recurrent miscarriage. The same regimen is suggested for late pregnancy complications by some, but not all, experts. Aspirin or low-molecular-weight heparin to improve pregnancy outcome in women with unexplained recurrent miscarriage has no benefit and should not be prescribed. Whether anticoagulant therapy prevents recurrent miscarriage in women with inherited thrombophilia or in women with severe pregnancy complications remains controversial because of inconsistent results from trials. Aspirin modestly decreases the risk of severe preeclampsia in women at high risk. Learning Objectives• To describe the association between pregnancy complications and thrombophilia both quantitatively and qualitatively • To describe the state of the evidence with respect to prevention of pregnancy complications with aspirin and/or heparin in various subgroups of women, particularly women with antiphospholipid syndrome and those with inherited thrombophilia

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Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force

Abstract: Daily low-dose aspirin beginning as early as the second trimester prevented clinically important health outcomes. No harms were identified, but long-term evidence was limited.

Cited by 428 publications

References 72 publications

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Fighting for the Next Generation: US Prematurity in 2030

Anticoagulation in pregnancy complications

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