Prevention of Preeclampsia with Aspirin in Multiple Gestations: A Systematic Review and Meta-analysis

Autor: Caroline Carpentier, Affette McCaw-Binns, Tessa S. Bergeron, Emmanuel Bujold, Stéphanie Roberge, Bahaeddine M Sibai
Rok vydání: 2016
Předmět:
medicine.medical_specialty
Pediatrics
Gestational Age
Severity of Illness Index
Preeclampsia
law.invention
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Randomized controlled trial
Pregnancy
Risk Factors
law
medicine
Humans
reproductive and urinary physiology
Randomized Controlled Trials as Topic
Aspirin
Fetal Growth Retardation
030219 obstetrics & reproductive medicine
Obstetrics
business.industry
Infant
Newborn
Obstetrics and Gynecology
Gestational age
medicine.disease
female genital diseases and pregnancy complications
Confidence interval
Pregnancy Complications
030220 oncology & carcinogenesis
Relative risk
Infant
Small for Gestational Age
Pediatrics
Perinatology and Child Health
Gestation
Small for gestational age
Female
Pregnancy
Multiple
business
Platelet Aggregation Inhibitors
medicine.drug
Zdroj: American Journal of Perinatology. 33:605-610
ISSN: 1098-8785
0735-1631
DOI: 10.1055/s-0035-1570381
Popis: Objective The objective of this study was to estimate the effect of low-dose aspirin in multiple gestations to prevent preeclampsia and small for gestational age (SGA) neonates. Methods A systematic review and meta-analysis were performed through electronic database searches. Randomized controlled trials (RCTs) of women with multiple gestations assigned to receive aspirin or placebo or no treatment were included. Outcomes included preeclampsia (mild and severe) and SGA neonates. Relative risks (RR) with their 95% confidence intervals (CI) were calculated. Result Out of 6,853 citations, 6 RCTS, including 898 pregnancies, were included. We observed a significant reduction in the risk of preeclampsia (RR, 0.67; 95% CI, 0.48–0.94) and mild preeclampsia (RR, 0.44; 95% CI, 0.24–0.82) but not severe preeclampsia (RR, 1.02; 95% CI, 0.61–1.72) with low-dose aspirin. The risk of SGA was not changed (RR, 1.09; 95% CI, 0.80–1.47). The reduction of preeclampsia was not different between women randomized before (RR, 0.86; 95% CI, 0.41–1.81) or after 16 weeks' gestation (RR, 0.64; 95% CI, 0.43–0.96) (p = 0.50). Conclusion There is low level of evidence supporting the use of low-dose aspirin for the prevention of preeclampsia and SGA neonates in multiple gestations.
Databáze: OpenAIRE
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