Preventing preeclampsia and its fetal complications with low-dose aspirin in East Asians and non-East Asians:A systematic review and meta-analysis

ABSTRACT

Background: Low-dose aspirin can reduce the incidence of preeclampsia and intrauterine growth restriction (IUGR). However, the effects of ethnicity upon low-dose aspirin’s efficacy has not been analyzed. Here, we comparatively evaluated the efficacy of low-dose aspirin in preventing preeclampsia and related fetal complications in East Asian and non-East Asian pregnant women at risk for preeclampsia. Methods: Several databases were searched for randomized controlled trials (RCTs) comparing low-dose aspirin with either placebo or no treatment in pregnant women at risk for preeclampsia. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for preeclampsia and related fetal outcomes were tabulated. Results: Low-dose aspirin significantly reduced preeclampsia risk in both East Asians (OR = 0.20, 95% CI: 0.11–0.35) and non-East Asians (OR = 0.84, 95% CI: 0.77–0.92). Low-dose aspirin significantly reduced IUGR risk in East Asians (OR = 0.36, 95% CI: 0.20–0.67) but not in non-East Asians (OR = 0.85, 95% CI: 0.41–1.77). Low-dose aspirin did not significantly reduce the risk of cesarean section in either East Asians (OR = 0.67, 95% CI: 0.14–3.22) or non-East Asians (OR = 1.01, 95% CI: 0.86–1.19). Conclusions: Low-dose aspirin is effective in reducing preeclampsia risk in both East Asians and non-East Asians and has differential effects in East Asians and non-East Asians with respect to IUGR.

KEYWORDS:

• Acetylsalicylic acid
• Asian
• aspirin
• intrauterine growth restriction
• IUGR
• preeclampsia

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Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article..

Funding

This work was financially supported by National Natural Science Foundation of China (Nos. 81070502, 81170585, 81100444). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

Conceived and designed the study: JG and HBQ. Performed the literature search, data extraction, and quality assessment: JG and HH. Analyzed the data: HH. Drafted the manuscript: JG.

Additional information

Funding

This work was financially supported by National Natural Science Foundation of China (Nos. 81070502, 81170585, 81100444). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.