Impact of low-dose aspirin exposure on obstetrical outcomes: a meta-analysis

References

• Duley L, Meher S, Hunter KE, et al. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2019;2019(10):1. doi:10.1002/14651858.CD004659.pub3
   Google Scholar
• Zhao S, Gu Y, Lewis DF, et al. Predominant basal directional release of thromboxane, but not prostacyclin, by placental trophoblasts from normal and preeclamptic pregnancies. Placenta. 2008;29(1):81–17. doi:10.1016/j.placenta.2007.08.007
   PubMed Web of Science ®Google Scholar
• Cadavid AP. Aspirin: the mechanism of action revisited in the context of pregnancy complications. Front Immunol. 2017;8:261. doi:10.3389/fimmu.2017.00261
   PubMed Web of Science ®Google Scholar
• ACOG. Committee Opinion No. 743: low-dose aspirin use during pregnancy. Obstet Gynecol. 2018;132(1):e44–e52.
   PubMedGoogle Scholar
• Jacobson RL, Brewer A, Eis A, et al. Transfer of aspirin across the perfused human placental cotyledon. Am J Obstet Gynecol. 1991;165(4 Pt 1):939–944. doi:10.1016/0002-9378(91)90444-v
   PubMed Web of Science ®Google Scholar
• Levy G, Garrettson LK. Kinetics of salicylate elimination by newborn infants of mothers who ingested aspirin before delivery. Pediatrics. 1974;53(2):201–210. doi:10.1542/peds.53.2.201
   PubMed Web of Science ®Google Scholar
• Levy G, Procknal JA, Garrettson LK. Distribution of salicylate between neonatal and maternal serum at diffusion equilibrium. Clin Pharmacol Ther. 1975;18(2):210–214. doi:10.1002/cpt1975182210
   PubMed Web of Science ®Google Scholar
• Turner JM, Robertson NT, Hartel G, et al. Impact of low-dose aspirin on adverse perinatal outcome: meta-analysis and meta-regression. Ultrasound Obstet Gynecol. 2020;55(2):157–169. doi:10.1002/uog.20859
   PubMed Web of Science ®Google Scholar
• Askie LM, Duley L, Henderson-Smart DJ, et al. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007;369(9575):1791–1798. doi:10.1016/S0140-6736(07)60712-0
   PubMed Web of Science ®Google Scholar
• Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402–414. doi:10.1097/AOG.0b013e3181e9322a
   PubMed Web of Science ®Google Scholar
• Roberge S, Villa P, Nicolaides K, et al. Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis. Fetal Diagn Ther. 2012;31(3):141–146. doi:10.1159/000336662
   PubMed Web of Science ®Google Scholar
• Roberge S, Nicolaides KH, Demers S, et al. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41(5):491–499. doi:10.1002/uog.12421
   PubMed Web of Science ®Google Scholar
• LeFevre ML, U.S. Preventive Services Task Force. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(11):819–826. doi:10.7326/M14-1884
   PubMed Web of Science ®Google Scholar
• Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097
   PubMed Web of Science ®Google Scholar
• Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. doi:10.1136/bmj.327.7414.557
   PubMed Web of Science ®Google Scholar
• Caritis S, Sibai B, Hauth J, et al. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med. 1998;338(11):701–705. doi:10.1056/NEJM199803123381101
   PubMed Web of Science ®Google Scholar
• Sibai BM, Caritis SN, Thom E, et al. Prevention of preeclampsia with low-dose aspirin in healthy, nulliparous pregnant women. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med. 1993;329(17):1213–1218. doi:10.1056/NEJM199310213291701
   PubMed Web of Science ®Google Scholar
• Choi YJ, Shin S. Aspirin prophylaxis during pregnancy: a systematic review and meta-analysis. Am J Prev Med. 2021;61(1):e31–e45. doi:10.1016/j.amepre.2021.01.032
   PubMed Web of Science ®Google Scholar
• Wallenburg HC, Dekker GA, Makovitz JW, et al. Low-dose aspirin prevents pregnancy-induced hypertension and pre-eclampsia in angiotensin-sensitive primigravidae. Lancet. 1986;1(8471):1–3. doi:10.1016/s0140-6736(86)91891-x
   PubMed Web of Science ®Google Scholar
• Benigni A, Gregorini G, Frusca T, et al. Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension. N Engl J Med. 1989;321(6):357–362. doi:10.1056/NEJM198908103210604
   PubMed Web of Science ®Google Scholar
• Schiff E, Peleg E, Goldenberg M, et al. The use of aspirin to prevent pregnancy-induced hypertension and lower the ratio of thromboxane A2 to prostacyclin in relatively high risk pregnancies. N Engl J Med. 1989;321(6):351–356. doi:10.1056/NEJM198908103210603
   PubMed Web of Science ®Google Scholar
• McParland P, Pearce JM, Chamberlain GV. Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. Lancet. 1990;335(8705):1552–1555. doi:10.1016/0140-6736(90)91377-m
   PubMed Web of Science ®Google Scholar
• Schröcksnadel H, Sitte B, Alge A, et al. Low-dose aspirin in primigravidae with positive roll-over test. Gynecol Obstet Invest. 1992;34(3):146–150. doi:10.1159/000292748
   PubMed Web of Science ®Google Scholar
• Viinikka L, Hartikainen-Sorri AL, Lumme R, et al. Low dose aspirin in hypertensive pregnant women: effect on pregnancy outcome and prostacyclin–thromboxane balance in mother and newborn. Br J Obstet Gynaecol. 1993;100(9):809–815. doi:10.1111/j.1471-0528.1993.tb14304.x
   PubMedGoogle Scholar
• Davies NJ, Gazvani MR, Farquharson RG, et al. Low-dose aspirin in the prevention of hypertensive disorders of pregnancy in relatively low-risk nulliparous women. Hypertens Pregnancy. 1995;14(1):49–55. doi:10.3109/10641959509058050
   Web of Science ®Google Scholar
• Kyle PM, Buckley D, Kissane J, et al. The angiotensin sensitivity test and low-dose aspirin are ineffective methods to predict and prevent hypertensive disorders in nulliparous pregnancy. Am J Obstet Gynecol. 1995;173(3 Pt 1):865–872. doi:10.1016/0002-9378(95)90356-9
   PubMed Web of Science ®Google Scholar
• Newnham JP, Godfrey M, Walters BJ, et al. Low dose aspirin for the treatment of fetal growth restriction: a randomized controlled trial. Aust N Z J Obstet Gynaecol. 1995;35(4):370–374. doi:10.1111/j.1479-828x.1995.tb02144.x
   PubMed Web of Science ®Google Scholar
• Bower SJ, Harrington KF, Schuchter K, et al. Prediction of pre-eclampsia by abnormal uterine Doppler ultrasound and modification by aspirin. Br J Obstet Gynaecol. 1996;103(7):625–629. doi:10.1111/j.1471-0528.1996.tb09829.x
   PubMedGoogle Scholar
• Morris JM, Fay RA, Ellwood DA, et al. A randomized controlled trial of aspirin in patients with abnormal uterine artery blood flow. Obstet Gynecol. 1996;87(1):74–78. doi:10.1016/0029-7844(95)00340-1
   PubMed Web of Science ®Google Scholar
• Wang Z, Li W. A prospective randomized placebo-controlled trial of low-dose aspirin for prevention of intra-uterine growth retardation. Chin Med J. 1996;109(3):238–242.
   PubMed Web of Science ®Google Scholar
• Bar J, Hod M, Pardo J, et al. Effect on fetal circulation of low-dose aspirin for prevention and treatment of pre-eclampsia and intrauterine growth restriction: Doppler flow study. Ultrasound Obstet Gynecol. 1997;9(4):262–265. doi:10.1046/j.1469-0705.1997.09040262.x
   PubMed Web of Science ®Google Scholar
• Bar J, Padoa A, Hod M, et al. Decreased pathological placental findings in aspirin-treated pregnant women at risk of hypertensive complications. Hypertens Pregnancy. 1997;16(3):435–444. doi:10.3109/10641959709031651
   Web of Science ®Google Scholar
• Gallery EDM, Ross MR, Hawkins M, et al. Low-dose aspirin in high-risk pregnancy? Hypertens Pregnancy. 1997;16(2):229–238. doi:10.3109/10641959709031640
   Web of Science ®Google Scholar
• Byaruhanga RN, Chipato T, Rusakaniko S. A randomized controlled trial of low-dose aspirin in women at risk from pre-eclampsia. Int J Gynaecol Obstet. 1998;60(2):129–135. doi:10.1016/s0020-7292(97)00257-9
   PubMed Web of Science ®Google Scholar
• Rotchell YE, Cruickshank JK, Gay MP, et al. Barbados low dose aspirin study in pregnancy (BLASP): a randomised trial for the prevention of pre-eclampsia and its complications. Br J Obstet Gynaecol. 1998;105(3):286–292. doi:10.1111/j.1471-0528.1998.tb10088.x
   PubMedGoogle Scholar
• McCowan LM, Harding J, Roberts A, et al. Administration of low-dose aspirin to mothers with small for gestational age fetuses and abnormal umbilical Doppler studies to increase birthweight: a randomised double-blind controlled trial. Br J Obstet Gynaecol. 1999;106(7):647–651. doi:10.1111/j.1471-0528.1999.tb08362.x
   PubMedGoogle Scholar
• Pattison NS, Chamley LW, Birdsall M, et al. Does aspirin have a role in improving pregnancy outcome for women with the antiphospholipid syndrome? A randomized controlled trial. Am J Obstet Gynecol. 2000;183(4):1008–1012. doi:10.1067/mob.2000.106754
   PubMed Web of Science ®Google Scholar
• Subtil D, Goeusse P, Houfflin‐Debarge V, et al. Aspirin (100 mg) used for prevention of pre-eclampsia in nulliparous women: the Essai Regional Aspirine Mere-Enfant study (part 1). BJOG. 2003;110(5):485–491. doi:10.1016/S1470-0328(03)02996-3
   PubMed Web of Science ®Google Scholar
• Yu CKH, Papageorghiou AT, Parra M, et al. Randomized controlled trial using low-dose aspirin in the prevention of pre-eclampsia in women with abnormal uterine artery Doppler at 23 weeks’ gestation. Ultrasound Obstet Gynecol. 2003;22(3):233–239. doi:10.1002/uog.218
   PubMed Web of Science ®Google Scholar
• Kaandorp SP, Goddijn M, van der Post JAM, et al. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med. 2010;362(17):1586–1596. doi:10.1056/NEJMoa1000641
   PubMed Web of Science ®Google Scholar
• Abramovici A, Jauk V, Wetta L, et al. Low-dose aspirin is associated with a reduction in spontaneous preterm birth among non-smokers. Am J Obstet Gynecol. 2013;208(1):S260–S261. doi:10.1016/j.ajog.2012.10.778
   PubMed Web of Science ®Google Scholar
• Ayala DE, Ucieda R, Hermida RC. Chronotherapy with low-dose aspirin for prevention of complications in pregnancy. Chronobiol Int. 2013;30(1–2):260–279. doi:10.3109/07420528.2012.717455
   PubMed Web of Science ®Google Scholar
• Ohno M, Girsen A, O’Malley K, et al. Does low-dose aspirin for preeclampsia prevention increase the risk of antepartum bleeding or placental abruption? Am J Obstet Gynecol. 2014;210(1):S189. doi:10.1016/j.ajog.2013.10.406
   Web of Science ®Google Scholar
• Schisterman EF, Silver RM, Lesher LL, et al. Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial. Lancet. 2014;384(9937):29–36. doi:10.1016/S0140-6736(14)60157-4
   PubMed Web of Science ®Google Scholar
• Abramovici A, Jauk V, Wetta L, et al. Low-dose aspirin, smoking status, and the risk of spontaneous preterm birth. Am J Perinatol. 2015;32(5):445–450. doi:10.1055/s-0034-1390352
   PubMed Web of Science ®Google Scholar
• Moore GS, Allshouse AA, Post AL, et al. Early initiation of low-dose aspirin for reduction in preeclampsia risk in high-risk women: a secondary analysis of the MFMU high-risk aspirin study. J Perinatol. 2015;35(5):328–331. doi:10.1038/jp.2014.214
   PubMed Web of Science ®Google Scholar
• Allshouse AA, Jessel RH, Heyborne KD. The impact of low-dose aspirin on preterm birth: secondary analysis of a randomized controlled trial. J Perinatol. 2016;36(6):427–431. doi:10.1038/jp.2016.3
   PubMed Web of Science ®Google Scholar
• Euser AG, Metz TD, Allshouse AA, et al. Low-dose aspirin for pre-eclampsia prevention in twins with elevated human chorionic gonadotropin. J Perinatol. 2016;36(8):601–605. doi:10.1038/jp.2016.55
   PubMed Web of Science ®Google Scholar
• Sentilhes L, Azria E, Schmitz T. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017;377(24):2399–2400.
   PubMed Web of Science ®Google Scholar
• Scazzocchio E, Oros D, Diaz D, et al. Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks: a randomized controlled study. Ultrasound Obstet Gynecol. 2017;49(4):435–441. doi:10.1002/uog.17351
   PubMed Web of Science ®Google Scholar
• Andrikopoulou M, Purisch SE, Handal-Orefice R, et al. Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women. Am J Obstet Gynecol. 2018;219(4):399.e1–399.e6. doi:10.1016/j.ajog.2018.06.011
   PubMed Web of Science ®Google Scholar
• Blomqvist L, Hellgren M, Strandell A. Acetylsalicylic acid does not prevent first-trimester unexplained recurrent pregnancy loss: a randomized controlled trial. Acta Obstet Gynecol Scand. 2018;97(11):1365–1372. doi:10.1111/aogs.13420
   PubMed Web of Science ®Google Scholar
• Sutton EF, Hauspurg A, Caritis SN, et al. Maternal outcomes associated with lower range stage 1 hypertension. Obstet Gynecol. 2018;132(4):843–849. doi:10.1097/AOG.0000000000002870
   PubMed Web of Science ®Google Scholar
• Tolcher MC, Sangi-Haghpeykar H, Aagaard KM. Low-dose aspirin (ASA) for preeclampsia prevention among high-risk women by ethnicity and race. Am J Obstet Gynecol. 2018;218(1):S564. doi:10.1016/j.ajog.2017.11.439
   Web of Science ®Google Scholar
• Hauspurg A, Sutton EF, Catov JM, et al. Aspirin effect on adverse pregnancy outcomes associated with stage 1 hypertension in a high-risk cohort. Hypertension. 2018;72(1):202–207. doi:10.1161/HYPERTENSIONAHA.118.11196
   PubMed Web of Science ®Google Scholar
• Gu W, Lin J, Hou Y-Y, et al. Effects of low-dose aspirin on the prevention of preeclampsia and pregnancy outcomes: a randomized controlled trial from Shanghai, China. Eur J Obstet Gynecol Reprod Biol. 2020;248:156–163. doi:10.1016/j.ejogrb.2020.03.038
   PubMed Web of Science ®Google Scholar
• Handal-Orefice R, Turitz A, Gyamfi-Bannerman C. 818: risk-reducing potential of aspirin among low-risk nulliparous, obese women. Am J Obstet Gynecol. 2020;222(1):S515. doi:10.1016/j.ajog.2019.11.833
   PubMed Web of Science ®Google Scholar
• Hoffman MK, Goudar SS, Kodkany BS, et al. Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10220):285–293. doi:10.1016/S0140-6736(19)32973-3
   PubMed Web of Science ®Google Scholar
• Tolcher MC, Sangi-Haghpeykar H, Mendez-Figueroa H, et al. Low-dose aspirin for preeclampsia prevention: efficacy by ethnicity and race. Am J Obstet Gynecol MFM. 2020;2(4):100184. doi:10.1016/j.ajogmf.2020.100184
   PubMed Web of Science ®Google Scholar
• Xiang X, Wang F, Zhao N, et al. Treatment of pregnancy-induced hypertension compared with labetalol, low dose aspirin and placebo. Cell Mol Biol. 2020;66(8):9–13. doi:10.14715/cmb/2017.63.11.16
   PubMed Web of Science ®Google Scholar
• Ling HZ, Jara PG, Bisquera A, et al. Maternal cardiac function in women at high risk for pre-eclampsia treated with 150 mg aspirin or placebo: an observational study. BJOG. 2020;127(8):1018–1025. doi:10.1111/1471-0528.16193
   PubMed Web of Science ®Google Scholar
• Bauserman M, Leuba SI, Hemingway-Foday J, et al. The efficacy of low-dose aspirin in pregnancy among women in malaria-endemic countries. BMC Pregnancy Childbirth. 2022;22(1):303. doi:10.1186/s12884-022-04652-9
   PubMed Web of Science ®Google Scholar
• Landman AJEMC, de Boer MA, Visser L, et al. Evaluation of low-dose aspirin in the prevention of recurrent spontaneous preterm labour (the APRIL study): a multicentre, randomised, double-blinded, placebo-controlled trial. PLoS Med. 2022;19(2):e1003892. doi:10.1371/journal.pmed.1003892
   PubMed Web of Science ®Google Scholar
• Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343(2):d5928. doi:10.1136/bmj.d5928
   PubMed Web of Science ®Google Scholar
• Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–634. doi:10.1136/bmj.315.7109.629
   PubMed Web of Science ®Google Scholar
• Thompson SG, Higgins JP. How should meta-regression analyses be undertaken and interpreted? Stat Med. 2002;21(11):1559–1573. doi:10.1002/sim.1187
   PubMed Web of Science ®Google Scholar
• Sanchez-Aranguren LC, Prada CE, Riaño-Medina CE, et al. Endothelial dysfunction and preeclampsia: role of oxidative stress. Front Physiol. 2014;5:372.
   PubMed Web of Science ®Google Scholar
• Bose P, Black S, Kadyrov M, et al. Heparin and aspirin attenuate placental apoptosis in vitro: implications for early pregnancy failure. Am J Obstet Gynecol. 2005;192(1):23–30. doi:10.1016/j.ajog.2004.09.029
   PubMed Web of Science ®Google Scholar
• Panagodage S, Yong HEJ, Da Silva Costa F, et al. Low-dose acetylsalicylic acid treatment modulates the production of cytokines and improves trophoblast function in an in vitro model of early-onset preeclampsia. Am J Pathol. 2016;186(12):3217–3224. doi:10.1016/j.ajpath.2016.08.010
   PubMed Web of Science ®Google Scholar
• Grosser N, Abate A, Oberle S, et al. Heme oxygenase-1 induction may explain the antioxidant profile of aspirin. Biochem Biophys Res Commun. 2003;308(4):956–960. doi:10.1016/s0006-291x(03)01504-3
   PubMed Web of Science ®Google Scholar
• Grosser N, Schröder H. Aspirin protects endothelial cells from oxidant damage via the nitric oxide–cGMP pathway. Arterioscler Thromb Vasc Biol. 2003;23(8):1345–1351. doi:10.1161/01.ATV.0000083296.57581.AE
   PubMed Web of Science ®Google Scholar
• Taubert D, Berkels R, Grosser N, et al. Aspirin induces nitric oxide release from vascular endothelium: a novel mechanism of action. Br J Pharmacol. 2004;143(1):159–165. doi:10.1038/sj.bjp.0705907
   PubMed Web of Science ®Google Scholar
• Thorp JA, Walsh SW, Brath PC. Low-dose aspirin inhibits thromboxane, but not prostacyclin, production by human placental arteries. Am J Obstet Gynecol. 1988;159(6):1381–1384. doi:10.1016/0002-9378(88)90560-1
   PubMed Web of Science ®Google Scholar
• Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013;71(Suppl. 1):S18–S25. doi:10.1111/nure.12055
   PubMed Web of Science ®Google Scholar