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

Tessa S. Bergeron; Stéphanie Roberge; Caroline Carpentier; Baha Sibai; Affette McCaw-Binns; Emmanuel Bujold

doi:10.1055/s-0035-1570381

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(06): 605-610
DOI: 10.1055/s-0035-1570381

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Tessa S. Bergeron

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada

,

Stéphanie Roberge

²Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada

,

Caroline Carpentier

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada

,

Baha Sibai

³Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, Texas

,

Affette McCaw-Binns

⁴Department of Community Health and Psychiatry, University of the West Indies, Mona Kingston, Jamaica

,

Emmanuel Bujold

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada

› Author Affiliations

Abstract

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.

Keywords

pregnancy - preeclampsia - multiple gestation - twin - aspirin

Full Text

References

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