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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
1   Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada
,
Stéphanie Roberge
2   Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada
,
Caroline Carpentier
1   Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada
,
Baha Sibai
3   Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, Texas
,
Affette McCaw-Binns
4   Department of Community Health and Psychiatry, University of the West Indies, Mona Kingston, Jamaica
,
Emmanuel Bujold
1   Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada
› Author Affiliations
Further Information

Publication History

22 August 2015

14 November 2015

Publication Date:
05 January 2016 (online)

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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
 

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