Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials
| Autor: | Bahaeddine M Sibai, Stéphanie Roberge, Affette McCaw-Binns, Emmanuel Bujold |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Gestational Age 030204 cardiovascular system & hematology law.invention Preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Randomized controlled trial Pregnancy Risk Factors law Humans Medicine reproductive and urinary physiology Randomized Controlled Trials as Topic Fetal Growth Retardation 030219 obstetrics & reproductive medicine Aspirin business.industry Obstetrics Infant Newborn Obstetrics and Gynecology Gestational age medicine.disease female genital diseases and pregnancy complications Relative risk Infant Small for Gestational Age Pediatrics Perinatology and Child Health Small for gestational age Platelet aggregation inhibitor Gestation Female business Platelet Aggregation Inhibitors |
| Zdroj: | American Journal of Perinatology. 33:781-785 |
| ISSN: | 1098-8785 0735-1631 |
| DOI: | 10.1055/s-0036-1572495 |
| Popis: | Objectives Meta-analyses of small to moderate size randomized controlled trials (RCTs) suggested that aspirin started before 17 weeks' gestation reduces the risk of preeclampsia and small-for-gestational-age (SGA) neonates. We evaluated data from large randomized trials originally excluded from meta-analyses. Methods We performed meta-analyses of RCTs including more than 350 participants that compared aspirin to placebo during pregnancy. Corresponding authors were contacted to obtain data according to gestational age. Outcomes included preeclampsia, severe preeclampsia, and SGA. Relative risks (RRs) with their 95% confidence intervals (CIs) were calculated. Results Data for women recruited before 17 weeks' gestation were obtained for three (50%) of the six eligible trials for a total of 11,949 participants including 3,293 recruited before 17 weeks' gestation with available data. We observed no impact of low-dose aspirin (60 mg) started before 17 weeks' gestation on the risk of preeclampsia (RR: 0.93; 95% CI: 0.75–1.15), severe preeclampsia (RR: 0.96; 95% CI: 0.71–1.28), or SGA (RR: 0.84; 95% CI: 0.56–1.26) and it was not statistically different than when started at or after 17 weeks' gestation. Conclusion Data from large randomized trials do not support greater benefits of low-dose aspirin (at 60 mg daily) when started before 17 weeks' gestation for the prevention of preeclampsia or SGA. |
| Databáze: | OpenAIRE |
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