Low-dose aspirin use in the first trimester of pregnancy and odds of congenital anomalies: A meta-analysis of randomized controlled trials.

Autor: Garza-Galvan ME; Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Mexico., Ferrigno AS; Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Mexico., Campos-Zamora M; Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts, USA., Bain PA; Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA., Easter SR; Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kim J; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Figueras F; Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic), IDIBAPS, University of Barcelona, Barcelona, Spain., Farber MK; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Lumbreras-Marquez MI; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2023 Feb; Vol. 160 (2), pp. 526-537. Date of Electronic Publication: 2022 Jul 27.
DOI: 10.1002/ijgo.14334
Abstrakt: Background: Daily low-dose aspirin (LDA) is recommended in high-risk pregnancies. However, its safety profile in the first trimester has not been well documented.
Objectives: To determine if LDA exposure during the first trimester of pregnancy is associated with higher odds of congenital structural anomalies.
Search Strategy: PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were systematically searched.
Selection Criteria: Randomized controlled trials (RCTs) that assigned participants to LDA (≤150 mg) or placebo/no intervention at less than 14 weeks of pregnancy were eligible.
Data Collection and Analysis: Random-effects models were performed using the inverse-variance method to calculate pooled effect sizes. Quality of evidence was appraised according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria.
Main Results: Eight RCTs that included 7564 participants assigned to receive daily LDA and 7670 participants that served as controls were analyzed. Low-certainty evidence showed no significant difference in the odds of congenital anomalies (odds ratio 0.87, 95% confidence interval 0.62-1.23, I 2  = 0%).
Conclusions: In this meta-analysis, there is no evidence to suggest safety concerns regarding LDA teratogenicity. However, given the overall low quality of evidence, further research (e.g. individual participant data meta-analysis) is needed to confirm LDA safety profile.
(© 2022 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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