ASPIRIN, NONSTEROID ANTIINFLAMMATION AS A PROPHYLAXIS IN REDUCING THE INCIDENCE OF PREECLAMPSIA: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.53555/nnmhs.v9i6.1741Keywords:
Aspirin, Preeclampsia, Prophylaxis, PreventionAbstract
Background: Numerous randomized trials have reported the efficacy and safety of aspirin use during pregnancy and the variable effects of aspirin on the incidence of preeclampsia.
Aim: This study aims to summarize and evaluate the efficacy of aspirin in preventing preeclampsia.
Methods: A systematic search strategy was conducted across several electronic reference databases (PubMed, Cochrane Library, Google Scholar) and included articles published between 2019–2023. Duplicate publications, review articles, editorials, and incomplete articles were excluded.
Results: Database searches identified a total of 92.832 articles. Of these, 100 articles passed the screening process, resulting in 22 articles for full-text assessment. Among them, 12 articles did not evaluate the outcome of interest. Hence, we found 10 appropriate studies included.
Conclusion: Low-dose aspirin administration prior to 20 weeks of gestation reduces the incidence of preeclampsia significantly. However, additional research is required to investigate the long-term efficacy and safety of low-dose aspirin administration during pregnancy by assessing the long-term outcomes in expectant women and their infants.
References
Hypertension G. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237–60.
Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: US Preventive Services Task Force Recommendation Statement. JAMA - J Am Med Assoc. 2021;326(12):1186–91.
Rolnik DL, Nicolaides KH, Poon LC. Prevention of preeclampsia with aspirin. Am J Obstet Gynecol [Internet] 2022;226(2):S1108–19. Available from: https://doi.org/10.1016/j.ajog.2020.08.045
Goodlin RC, Haesslein HO, Fleming J. Aspirin for the Treatment of Recurrent Toxæmia. Lancet. 1978;312(8079):51.
Beaufils M, Donsimoni R, Uzan S, Colau JC. PREVENTION OF PRE-ECLAMPSIA BY EARLY ANTIPLATELET THERAPY. Lancet. 1985;325(8433).
Gu W, Lin J, Hou YY, Lin N, Song MF, Zeng WJ, et al. Effects of low-dose aspirin on the prevention of preeclampsia and pregnancy outcomes: A randomized controlled trial from Shanghai, China. Eur J Obstet Gynecol Reprod Biol [Internet] 2020;248(910):156–63. Available from: https://doi.org/10.1016/j.ejogrb.2020.03.038
Tolcher MC, Sangi-Haghpeykar H, Mendez-Figueroa H, Aagaard KM. Low-dose aspirin for preeclampsia prevention: efficacy by ethnicity and race. Am J Obstet Gynecol MFM [Internet] 2020;2(4):100184. Available from: https://doi.org/10.1016/j.ajogmf.2020.100184
Shanmugalingam R, Wang XS, Motum P, Fulcher I, Lee G, Kumar R, et al. Clinical influence of nonadherence with prophylactic aspirin in preventing preeclampsia in high-risk pregnancies: A multicenter, prospective, observational cohort study. Hypertension. 2020;1125–32.
Abdi N, Rozrokh A, Alavi A, Zare S, Vafaei H, Asadi N, et al. The effect of aspirin on preeclampsia, intrauterine growth restriction and preterm delivery among healthy pregnancies with a history of preeclampsia. J Chinese Med Assoc. 2020;83(9):852–7.
Hoffman MK, Goudar SS, Kodkany BS, Metgud M, Somannavar M, Okitawutshu J, et al. Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10220):285–93.
Huai J, Lin L, Juan J, Chen J, Li B, Zhu Y, et al. Preventive effect of aspirin on preeclampsia in high-risk pregnant women with stage 1 hypertension. J Clin Hypertens. 2021;23(5):1060–7.
Do NC, Vestgaard M, Áasbjöornsdáottir B, Nørgaard SK, Andersen LLT, Jensen DM, et al. Unchanged Prevalence of Preeclampsia After Implementation of Prophylactic Aspirin for All Pregnant Women With Preexisting Diabetes: A Prospective Cohort Study. Diabetes Care. 2021;44(10):2252–9.
Shen L, Martinez-Portilla RJ, Rolnik DL, Poon LC. ASPRE trial: risk factors for development of preterm preeclampsia despite aspirin prophylaxis. Ultrasound Obstet Gynecol. 2021;58(4):546–52.
Diguisto C, Le Gouge A, Marchand MS, Megier P, Ville Y, Haddad G, et al. Low-dose aspirin to prevent preeclampsia and growth restriction in nulliparous women identified by uterine artery Doppler as at high risk of preeclampsia: A double blinded randomized placebo-controlled trial. PLoS One. 2022;17(10 October):1–10.
Lin L, Huai J, Li B, Zhu Y, Juan J, Zhang M, et al. A randomized controlled trial of low-dose aspirin for the prevention of preeclampsia in women at high risk in China. Am J Obstet Gynecol [Internet] 2022;226(2):251.e1251.e12. Available from: https://doi.org/10.1016/j.ajog.2021.08.004
Gan J, He H, Qi H. Preventing preeclampsia and its fetal complications with low-dose aspirin in East Asians and non-East Asians:A systematic review and meta-analysis. Hypertens Pregnancy. 2016;35(3):426–35.
Choi YJ, Shin S. Aspirin Prophylaxis During Pregnancy: A Systematic Review and Meta-Analysis. Am J Prev Med [Internet] 2021;61(1):e31–45. Available from: https://doi.org/10.1016/j.amepre.2021.01.032
Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: A meta-analysis. Vol. 116, Obstetrics and Gynecology. 2010.
Di Renzo GC, Gratacos E, Kurtser M, Malone F, Nambiar S, Sierra N, et al. Good clinical practice advice: First trimester screening and prevention of pre-eclampsia in singleton pregnancy. Int J Gynecol Obstet. 2019;144(3).
Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynecol Obstet. 2019;145(S1):1–33.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
