medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2023, Number 05

<< Back Next >>

Ginecol Obstet Mex 2023; 91 (05)

Prophylactic use of aspirin for the prevention of preeclampsia and its complications in high and moderate risk pregnancies

Rivera-Félix LM, Cruzado-Ulloa FA, Quiñones-Colchado ER, Cuya-Candela E, Fernández-Domínguez SA, Miranda-Prada AS

Language: Spanish
References: 32
Page: 324-343
PDF size: 278.95 Kb.


ABSTRACT

Objective: To synthesize the available evidence of the last 10 years regarding the use of aspirin for the prevention of preeclampsia and its complications in high and moderate risk pregnancies.
Methodology: Five electronic databases [Pubmed/Medline, ProQuest, Lilacs, HINARI, and Cochrane Central Register of Controlled Trials (CENTRAL)] were reviewed. Randomized controlled clinical trials in Spanish and English published between 01/01/2010 and 01/01/2020 were considered. The DeCS and MeSH controlled vocabulary terms were used in the different interfaces. In the case of ProQuest, free vocabulary terms were also introduced. The details of the search strategy are displayed in annexes.
Results: 410 studies were identified, of which 8 studies that met the eligibility criteria were selected. 2 studies found a reducing effect of aspirin on the incidence of preeclampsia compared to placebo and another 2 studies found the same effect on the incidence of preeclampsia with preterm delivery. No studies with low risk of bias were found that have reported a significant effect of aspirin on the complications of preeclampsia, nor on preeclampsia with and without criteria of severity.
Conclusions: there is evidence indicating that low-dose aspirin before 16 weeks of gestation reduces the incidence of preeclampsia, this is due to the reducing impact it has on the incidence of preeclampsia with preterm delivery. Despite the results found, the information is still limited, and it is necessary to have a greater number of studies with low risk of bias.


REFERENCES

  1. World Health Organization. WHO Recommendations onAntenatal Care for a Positive Pregnancy Experience. WHOPress; 2016.

  2. Correa P, Palmeiro Y, Soto M, Ugarte C, Illanes S.Etiopathogenesis, prediction, and prevention of preeclampsia.Hypertens Pregnancy 2016; 35 (3): 280-94.10.1080/10641955.2016.1181180.

  3. Say L, Chou D, Gemmill A, Tunçalp Ö, et al. Global causesof maternal death: a WHO systematic analysis. Lancet2014; 2 (6): E323-E333. https://doi.org/10.1016/S2214-109X(14)70227-X

  4. Bryce-Moncloa A, Alegría-Valdivia E, Valenzuela-RodríguezG, Larrauri-Vigna CA, Urquiaga-Calderón J, San Martín-San Martín MG. Hipertensión en el embarazo. rev. peru.ginecol. obstet 2018; 64 (2): 191-196. http://www.scielo.org.pe/scielo.php?script = sci_arttext&pid = S2304-

  5. 51322018000200006&lng = es5. Turbeville, Hannah R, and Jennifer M Sasser. Preeclampsiabeyond pregnancy: long-term consequences for motherand child. Am J Physiol Renal Physiol 2020; 318 (6): F1315-F1326. doi:10.1152/ajprenal.00071.2020

  6. Yanque-Robles, Omar et al. “Clinical practice guideline forthe prevention and management of hypertensive disordersof pregnancy.” “Guía de práctica clínica para la prevencióny el manejo de la enfermedad hipertensiva del embarazo.”Revista Colombiana de Obstetricia y Ginecologia 2022;

  7. 73 (1): 48-141. doi:10.18597/rcog.38107. Ma’ayeh M, Rood KM, Kniss D, et al. Novel Interventions forthe Prevention of Preeclampsia. Curr Hypertens Rep 2020;22. https://doi.org/10.1007/s11906-020-1026-8

  8. Mirabito K, Neuman R, Visser W, Jan A, Versmissen J. Aspirinfor the prevention and treatment of pre‐eclampsia:A matter of COX‐1 and/or COX‐2 inhibition? Basic ClinPharmacol Toxicol 2020; 127 (2): 132-41. doi:10.1111/bcpt.13308

  9. Atallah A, Lecarpentier E, Goffinet F, Doret-Dion M,Gaucherand P, Tsatsaris V. Aspirin for prevention of preeclampsia.Drugs 2017; 77 (17): 1819-31. doi:10.1007/s40265-017-0823-0

  10. Urrútia G, Bonfill X. Declaración PRISMA: una propuestapara mejorar la publicación de revisiones sistemáticas ymetaanálisis. Med Clin (Barc) 2010; 135 (11): 507-11. doi:10.1016/j.medcli.2010.01.015

  11. Jadad AR, Andrew MR, Carroll D, Jenkinson C, John MD,Reynolds DJ, Gavaghan HJ. Assessing the quality of reportsof randomized clinical trials: Is blinding necessary?Controlled Clinical Trials 1996; 17: 1-12. https://doi.org/10.1016/0197-2456(95)00134-4

  12. Mervi H, Hannu M, Helena T, Seppo H, Sinikka N, Juha R. Lowdoseaspirin therapy and hypertensive pregnancy complicationsin unselected IVF and ICSI patients: a randomized, placebocontrolled,double-blind study Human Reproduction 2010;25 (12): 2972-77, https://doi.org/10.1093/humrep/deq286

  13. Ashraf J, et al. Evaluation of the effect of metformin andaspirin on utero placental circulation of pregnant womenwith PCOS. Iranian J Reprod Med 2012; 10 (3): 265-70.PMID: 25243003

  14. Villa P, Kajantie E, Räikkönen K, Pesonen AK, HämäläinenE, Vainio M. Aspirin in the prevention of pre-eclampsia inhigh-risk women: a randomized placebo-controlled PREDOTrial and a meta-analysis of randomized trials. BJOG 2012;120 (1): 64-74. doi:10.1111/j.1471-0528.2012.03493.x

  15. Ayala DE, Ucieda R, Hermida RC. Chronotherapy WithLow-Dose Aspirin for Prevention of Complications in Pregnancy,Chronobiology International 2013; 30: 260-7 .doi:10.3109/07420528.2012.717455

  16. Odibo AO, Goetzinger KR, Odibo L, Tuuli MG. Early predictionand aspirin for prevention of pre-eclampsia (EPAPP) study:a randomized controlled trial. Ultrasound Obstet Gynecol2015; 46: 414-18. https://doi.org/10.1002/uog.14889

  17. Liu FM, Zhao M, Wang M, Yang HL, Li L. Effect of regular oralintake of aspirin during pregnancy on pregnancy outcomeof high-risk pregnancy-induced hypertension syndromepatients. Eur Rev Med Pharmacol Sci 2016; 20 (23): 5013-16. PMID: 27981529

  18. Rolnik D, Wright D, Poon L, O'Gorman N, Syngelaki A,Matallana C, et al. Aspirin versus placebo in pregnanciesat high risk for preterm preeclampsia. N Engl J Med 2017;377 (7): 613-22. doi:10.1056/NEJMoa1704559

  19. Hoffman MK, et al. Low-dose aspirin for the preventionof preterm delivery in nulliparous women with a singletonpregnancy (ASPIRIN): a randomised, double-blind,placebo-controlled trial. Lancet 2020; 395 (10220): 285-93.Doi:10.1016/S0140-6736(19)32973-3

  20. Higgins J, Green S. Cochrane Handbook for SystematicReviews of Interventions. Version 5.1.0. The Cochrane Collaboration.2011; 0 (0): p. 1-639. https://es.cochrane.org/sites/es.cochrane.org/files/public/uploads/Manual_Cochrane_510_reduit.pdf

  21. Seidler A, Askie L, Ray J. Optimal aspirin dosing for preeclampsiaprevention. Am J Obstet Gynecol 2018; 219 (1):117-18. doi:10.1016/j.ajog.2018.03.018

  22. Jie Gan, Huan He, Hongbo Qi. Preventing preeclampsiaand its fetal complications with low-dose aspirin in EastAsians and non-East Asians: A systematic review and metaanalysis,Hypertension in Pregnancy 2016; 35: (3): 426-35. doi:10.1080/10641955.2016.1178772

  23. Xu T, Zhou F, Deng C, Huang G, Li J, Wang X. Low-dose aspirinfor preventing preeclampsia and its complications: ameta-analysis. J Clin Hypertens (Greenwich) 2015; 17 (7):567-73. doi:10.1111/jch.12541

  24. Cui Y, Zhu B, Zheng F. Low-dose aspirin at ≤16 weeks ofgestation for preventing preeclampsia and its maternaland neonatal adverse outcomes: A systematic review andmeta-analysis. Exp Ther Med 2018; 15 (5): 4361-69. doi:10.3892/etm.2018.5972

  25. Chaemsaithong P, Cuenca D, Plana M, Gil M, Poon L. Doeslow-dose aspirin initiated before 11 weeks' gestation reducethe rate of preeclampsia? Am J Obstet Gynecol 2020;222 (5): 437-50. doi:10.1016/j.ajog.2019.08.047

  26. Roberge S, et al. The role of aspirin dose on the preventionof preeclampsia and fetal growth restriction: systematicreview and meta-analysis. Am J Obstet Gynecol 2017; 216(2): 110-120.e6. doi:10.1016/j.ajog.2016.09.076

  27. Duley L, et al. Antiplatelet agents for preventing preeclampsiaand its complications. The Cochrane databaseof systematic reviews 2019. doi:10.1002/14651858.CD004659.pub3

  28. US Preventive Services Task Force. Screening for Preeclampsia.JAMA 2017; 317 (16): 1661-67. doi:10.1001/jama.2017.3439

  29. Roberge S, Sibai B, McCaw A, Bujold E. Low-dose aspirinin early gestation for prevention of preeclampsia andsmall-for-gestational-age neonates: meta-analysis of largerandomized trials. Am J Perinatol 2016; 33 (8): 781-85.doi:10.1055/s-0036-1572495

  30. Roberge S, Bujold E, Nicolaides K. Aspirin for the preventionof preterm and term preeclampsia: systematic review andmetaanalysis. Am J Obstet Gynecol 2018; 218 (3): 287-293.doi:10.1016/j.ajog.2017.11.561

  31. Igboanugo S, Chen A, Mielke J. Maternal risk factors forbirth asphyxia in low-resource communities. A systematicreview of the literature. J Obstet Gynaecol. 2020; 40 (8):1039-55. doi:10.1080/01443615.2019.1679737

  32. Instituto Nacional Materno Perinatal. Guía de PrácticaClínica para la prevención y manejo de Preeclampsia yEclampsia. Guía de Práctica Clínica. Lima: INMP; 2017.http://bvs.minsa.gob.pe/local/MINSA/4220.pdf




2020     |     www.medigraphic.com