Aspirin prevents preeclampsia and complications
The Journal of Family Practice. 2003 December;52(12):919-941
December 1, 2003|The Journal of Family Practice
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- BACKGROUND: Diabetes, renal disease, hypertension, and a personal or family history of preeclampsia confer a high risk of preeclampsia. Early identification and treatment of women prone to preeclampsia could reduce its risk and associated sequelae. Randomized trials evaluating aspirin’s effectiveness for treating preeclampsia show a trend towards benefit, but most of these studies have been small.
- POPULATION STUDIED: This systematic review represents a total of 12,416 high-risk women. The studies included in this analysis represent women of various ages and used different criteria for defining women as high-risk.
- STUDY DESIGN AND VALIDITY: This was a meta-analysis of randomized trials that assessed aspirin’s therapeutic benefit in women with historical risk factors for preeclampsia. The authors searched multiple electronic scientific databases (MEDLINE, EMBASE, Cochrane Library, National Research Register, SCISEARCH, and conference proceedings) and reference lists from primary and review articles to identify an exhaustive list of pertinent research. They contacted researchers to find unpublished studies.
- OUTCOMES MEASURED: The primary outcomes in the majority of included studies were preeclampsia and perinatal death. Some studies reported other clinically relevant maternal or perinatal sequelae, such as preterm birth, birth weight, and antenatal bleeding or placental abruption.
- RESULTS: Treatment with aspirin, in doses ranging from 50 mg to 150 mg, started no earlier than at 12 weeks of pregnancy and continued, in most cases, until delivery. Fifty percent of the trials analyzed data based on an intention-to-treat protocol; the other trials failed to report this information. Follow-up for all 14 trials was >90%.
PRACTICE RECOMMENDATIONS
This meta-analysis shows that the use of aspirin in pregnant women predisposed to preeclampsia significantly reduces the rates of preeclampsia and perinatal death, without evidence of harm. A recent Cochrane review showed similar results.1It is reasonable to recommend low-dose aspirin therapy to women who have 1 or more risk factors for preeclampsia.
