Abstract

META-ANALYSIS: EARLY LOW-DOSE ASPIRIN FOR PREVENTION OF SEVERE AND MILD PREECLAMPSIA

Faris Ali Alnemer, Hossam Abdulraman Jawi*, Mawaddah Talal Alahmadi, Marwah Khan, Ebtihal Mohammed Masrahi, Abdulaziz Faisal Wanes Alrubayyi, Ashraf Omar Hawsawi, Waleed Khalid Nawwab, Hanady Nasser Almisrea, Bayan Mohammed Alsharif, Joanne Azmy Filimban

Abstract

Background and Purpose: Aspirin is currently the maximum widely prescribed treatment in the prevention of cardiovascular headaches. The indications for the use of aspirin during pregnancy are, but, the issue of plenty controversy. Since the first evidence of the obstetric efficacy of aspirin in 1985, several studies have attempted to decide the impact of low dose aspirin at the prevalence of preeclampsia, with very arguable consequences. Massive meta-analyses consisting of individual patient data have proven that aspirin is powerful in stopping preeclampsia in high-danger patients, particularly people with a records of preeclampsia. The Aim of this work is to provide cumulative data about the effect of early low-dose aspirin for prevention of severe and mild preeclampsia in pregnant women. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Gynecology and Obstetrics RCTs, clinical trials, and comparative studies, which studied the outcome of Aspirin group versus Placebo group for prevention of severe and mild preeclampsia in pregnant women. A meta- analysis was done using fixed and random-effect methods. The primary outcome was severe preeclampsia. Secondary outcome was mild preeclampsia. Results: A total of 5 studies were identified involving837 patients, with 421 patients in Aspirin group, and 416 patients in Placebo group. Regarding primary outcome measure, the fixed-effects model of the meta-analysis study showed highly significant decrease in severe preeclampsia in Aspirin group compared to Placebo group (p< 0.01). Regarding secondary outcome measure, the fixed-effects model of the meta-analysis study showed highly significant decrease in mild preeclampsia in Aspirin group compared to Placebo group (p = 0.006). Conclusion: To conclude, early dose aspirin provide positive effect on mild and severe preeclampsia but when given in late pregnancy may have a lesser effect.

Keywords: Early low-dose aspirin, Preeclampsia.