Prevention of Preeclampsia with Aspirin Therapy in the Second Trimester and Pregnancy Outcome: A Meta-analysis

Abstract

Background: Low-dose aspirin (LDA, range from 60-150 mg/d) therapy has been used to prevent preeclampsia (PE) for many years. However, whether LDA could positively affect pregnancy outcome remains unknown. Purpose: We performed this meta-analysis to assess the effectiveness of LDA therapy in women at high risk for PE. Methods: We searched studies published from January 1985 to February 2015. All the studies were search from the databases of PubMed, EMBASE, Cochrane, ScienceDirect, and Biosis Preview. The association between PE and pregnancy outcome with aspirin therapy was assessed by odds ratios (ORs) and 95% confidence intervals (CIs). Results: Thirteen articles involving 6735 participants were included in the final meta-analysis. When all studies were pooled into the meta-analysis, a statistically significant effect was found among pregnant women who underwent LDA therapy during their second trimester (14 to 28 weeks of gestation) to reduce PE (OR=0.72, 95% CI=0.54–0.95). Meanwhile, no difference was noted in the pregnancy outcomes including low birth weight (birth weight of 2,500 g or less in a live born infant) (OR=1.06, 95% CI=0.88–1.29), postpartum haemorrhage (blood loss more than 500 ml within 24 h after delivery) (OR=1.09, 95% CI=0.85–1.40), intrauterine growth restriction (IUGR, the fetal weight was below the 10th percentile for gestational and the neonatal birth weight fell below the 10th percentile) (OR=0.66, 95% CI=0.42–1.06), and pre-term delivery (diagnosed <37 + 0 weeks of gestation) (OR=0.78, 95% CI=0.57–1.05). Conclusions: The present meta-analysis suggests that the incidence of PE was statistically significant between LDA therapy groups and placebo groups. Furthermore, LDA therapy was not associated with pregnancy outcome including fetal birth weight, postpartum haemorrhage, IUGR, and preterm delivery. Harm from aspirin therapy was not observed in our study.