Low-Dose Aspirin in Primigravidae with Positive Roll-Over Test

Schröcksnadel, H.; Sitte, B.; Alge, A; Steckel-Berger, Gabriele; Schwegel, Philipp; Pastner, E; Daxenbichler, G.; Hansen, Hans Erik; Dapunt, O

doi:10.1159/000292748

Cited by 23 publications

(8 citation statements)

References 11 publications

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“…PND was reported in 21 studies. Regardless of the dose used, LDA started after 16 weeks' gestation had no effect on the risk of PND (RR, 0.90; 95% CI, 0.78–1.03; P = 0.12).…”

Section: Resultsmentioning

confidence: 95%

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Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

Turner

Robertson

Härtel

2020

Ultrasound in Obstet & Gyne

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CONTRIBUTIONWhat are the novel findings of this work? Aspirin intake, when commenced at ≤ 16 weeks' gestation at a dose ≥ 100 mg, results in a reduction in the risk of perinatal death, independently of its concomitant beneficial effect on reducing the risk of pre-eclampsia and preterm birth. What are the clinical implications of this work?Given that low-dose aspirin is a simple, cheap and effective intervention and is relatively well tolerated by women, our results suggest that it may be reasonable to consider its use in a wider, more general context, prior to 16 weeks' gestation, to improve perinatal outcome. ABSTRACTObjective To perform a meta-analysis and metaregression of randomized controlled trials (RCTs) to evaluate the impact of low-dose aspirin (LDA) on perinatal outcome, independent of its effect on pre-eclampsia (PE), preterm birth and low birth weight.

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“…PND was reported in 21 studies. Regardless of the dose used, LDA started after 16 weeks' gestation had no effect on the risk of PND (RR, 0.90; 95% CI, 0.78–1.03; P = 0.12).…”

Section: Resultsmentioning

confidence: 95%

“…Following review of the abstracts, 119 potentially suitable trials were selected for full review. Of these, 40 studies involving 34 807 participants, met the inclusion criteria and were included in the final analysis (Figure ).…”

Section: Resultsmentioning

confidence: 99%

Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

Turner

Robertson

Härtel

2020

Ultrasound in Obstet & Gyne

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“…The literature search identified 8377 citations from which we identified 1104 potentially eligible studies that were completely reviewed (Figure ). The inclusion criteria were met by 66 studies, but only 42 of those were included (27 222 women randomized) in the final analysis because several studies recruited over a range of gestational age overlapping 16 weeks. Studies included nulliparous women or women identified at high risk for pre‐eclampsia based on medical history and/or ultrasonographic findings (Table S1).…”

Section: Resultsmentioning

confidence: 99%

Prevention of perinatal death and adverse perinatal outcome using low‐dose aspirin: a meta‐analysis

Roberge

Nicolaides

Demers

et al. 2013

Ultrasound in Obstet & Gyne

354

237

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“…A total of 13 studies reported perinatal mortality [1,4,15,17,27,29,31,33,35,36,39,41-43] (Table 1). The effect of aspirin alone showed no significant effect on risk of stillbirths (RR= 1.15; 95% CI: 0.88 to 1.49) (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

Impact of interventions to prevent and manage preeclampsia and eclampsia on stillbirths

et al. 2011

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BackgroundPre-eclampsia and Eclampsia are relatively common complications of pregnancy, leading to considerable maternal and fetal mortality and morbidity. We sought to review the effect of aspirin, calcium supplementation, antihypertensive agents and magnesium sulphate on risk stillbirths.MethodsA systematic literature search was conducted to identify studies evaluating the above interventions. We used a standardized abstraction and grading format and performed meta-analyses where data were available from more than one studies. The estimated effect on stillbirths was determined by applying the standard Child Health Epidemiology Reference Group (CHERG) rules for multiple outcomes. For interventions with insufficient evidence for overall effect, a Delphi process was undertaken to estimate effectiveness.ResultsWe identified 82 relevant studies. For aspirin, maganesium sulphate and use of antihypertensive we found an insignificant decrease in stillbirth and perinatal mortality. For calcium supplementation, there was a borderline significant reduction in stillbirths (RR 0.81, 95 % CI 0.63-1.03). We undertook a Delphi consultation among experts to assess the potential impact of a package of interventions for the management of pre-eclampsia and eclampsia (antihypertensive, magnesium sulphate and C-section if needed). The Delphi process suggested 20% reduction each in both antepartum and intrapartum stillbirths with the use of this package.ConclusionsDespite promising benefits of calcium supplementation and aspirin use cases on maternal morbidity and eclampsia in high risk cases, further work is needed to ascertain their benefits in relation to stillbirths. The Delphi process undertaken for assessing potential impact of a package of interventions indicated that this could be associated with 20% reduction in stillbirths, for input into LiST.

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Low-Dose Aspirin in Primigravidae with Positive Roll-Over Test

Cited by 23 publications

References 11 publications

Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

Prevention of perinatal death and adverse perinatal outcome using low‐dose aspirin: a meta‐analysis

Impact of interventions to prevent and manage preeclampsia and eclampsia on stillbirths

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