Preventing Preeclampsia With Aspirin: Does Dose or Timing Matter?

Abstract

(Am J Obstet Gynecol. 2017;216(2):95–97) This editorial addresses 2 meta-analyses on aspirin use to prevent preeclampsia. Published in the February 2017 issue of the American Journal of Obstetrics and Gynecology, both focus on the clinical questions of the impact of aspirin dose and timing on preeclampsia. Roberge et al, the same team that published an influential meta-analysis in 2010 suggesting that starting aspirin ≤16 weeks’ gestation is very effective in preventing preeclampsia, published a new meta-analysis in this issue that examines the impact of the dose of aspirin and revisits the 16 weeks’ gestation threshold, updating their meta-analysis with 3 new trials. In this meta-analysis, Roberge et al found a dose-dependent effect where doses of 100 mg of aspirin seemed more effective than lower doses, although this dose-dependent relationship disappeared in studies that randomized women >16 weeks’ gestation.