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Meta-analysis
(first author) | Onset of treatment | Inclusion criteria | Intervention | Methods |
Results |
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Duley et al. Cochrane
Review
2007 [15] | Before and after 20 weeks of gestation | High risk criteria:
Previous severe preeclampsia
Chronic hypertension
Renal disease
Autoimmune disease
Diabetes | Antiplatelet agent (low dose aspirin or dipyridamole)
versus placebo or no antiplatelet agent | 59 trials (37,560 women) with low, moderate, and high risk groups treated with or without antiplatelet agents
Outcome:
preeclampsia
Secondary outcome: preterm birth and neonatal outcome | 17% risk reduction with use of antiplatelet agents (RR 0.83, 95% CI 0.77, 0.89) |
|
Trivedi
2011 [16] | 7–32 weeks of gestation | High risk criteria:
Previous severe preeclampsia
Essential hypertension
Underlying vascular disorder
Gestational diabetes mellitus
Maternal age > 40
Positive Doppler ultrasonography | Low-dose aspirin 40–160 mg
versus placebo | 19 trials with low risk group (16,550 women) and high risk group (11,687 women) for developement of preeclampsia
Each group treated with low-dose aspirin or placebo
Outcome:
preeclampsia
Secondary outcome: preterm delivery (<37 week) and IUGR | High risk group:
preeclampsia incidence: 10.7% low-dose aspirin group, 12.5% placebo group → risk reduction of preeclampsia with low-dose aspirin: 21% (RR 0.79, 95% CI 0.65, 0.97)
16% reduction in risk for preterm delivery
(RR 0.84, 95% CI 0.71, 0.99)
Low risk group:
preeclampsia incidence: 4.3% low-dose aspirin group, 4.4% placebo group → no significant risk reduction of preeclampsia wtih low-dose aspirin (RR 0.86, 95% CI 0.64, 1.17)
2% reduction in risk for preterm delivery
(RR 0.98, 95% CI 0.90, 1.07) |
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Roberge et al.
2012 [17] | Before 16 weeks of gestation | Risk factors:
Chronic hypertension
Previous severe preeclampsia
Abnormal uterine doppler
Obesity
First pregnancy
Sjögren Syndrome | Low dose asprin 50–150 mg
versus placebo | 5 trials with 556 women at risk of preeclampsia treated with low dose aspirin or placebo
Outcome:
preterm and term preeclampsia | Risk reduction of preterm preeclampsia
with low dose aspirin: 89%
(RR 0.11, 95% CI 0.04, 0.33)
No effects of low dose aspirin on term preeclampsia
(RR 0.98, 95% CI 0.42, 2.33) |
|
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Villa et al. 2013 [18] | At/before 16 weeks of gestation | Risk factors:
Abnormal uterine artery doppler flow velocimetry | Low dose aspirin 50–150 mg
versus placebo/no treatment | 346 women treated with aspirin or placebo
Outcome:
preeclampsia
Secondary outcome: preterm (<37 week), term or severe preeclampsia | Low dose aspirin group: significant reduced risk of preeclampsia (RR 0.6, 95% CI 0.37–0.83) and severe preeclampsia (RR 0.3, 95% CI 0.11–0.69) |
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