Prevention of gravidic endothelial hypertension by aspirin treatment administered from the 8th week of gestation

Abstract

The aim of this study was to evaluate whether low doses of aspirin (100 mg per day) administered to a homogeneous population of women early (8-10 weeks) during their first pregnancy improved the outcome of gestation hypertensive disorders. This study was performed at the Blida Hospital, where many early deliveries and pregnancy complications are observed. A total of 164 women were either treated (82) or used as controls (82). Treatment increased the gestation length by 12 days on average, thus triggering an approximate 150-g increase in newborn weight. This consistently improved the outcome for all patients with respect to all parameters investigated. Overall, the relative risk of developing hypertensive disorders of gestation was reduced to 0.07 (confidence interval¼0.01-0.51). In our series, we did not observe deleterious consequences for the fetus (teratogenicity and fetotoxicity) or adverse outcomes for the mothers. Despite the limited number of patients analyzed, the present study is one of the largest investigating early aspirin treatment of gestational hypertensive diseases. In addition, the time of aspirin administration is among the earliest yet examined. The data tend to confirm the results obtained from other cohorts on the overall benefit of aspirin treatment for gestational disorders. In the future, molecular or ultrasonographic markers of these diseases could help to screen patients before applying the treatment.

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

“…This finding is in agreement with a similar meta‐analysis published in 2010. Since then, four additional randomized trials that recruited high‐risk women prior to 16 weeks' gestation were published and their findings were consistent with our previous results. Moreover, the addition of two trials changed the conclusion regarding the effect of aspirin started after 16 weeks from insufficient evidence of effect to evidence of modest, but significant, reduction of the risk of pre‐eclampsia.…”

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

“…Five studies reported PND as an outcome. The meta‐analysis demonstrated a significant reduction in the risk of PND (RR, 0.47; 95% CI, 0.25–0.88; P = 0.02; NNT, 92; 95% CI, 49–463) (Figure 2a).…”

“…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 ).…”

“…Assessment of bias revealed that 21 (52.5%) studies were at low risk of bias (Figure S1). Nine (22.5%) studies had a high risk in one or more domains, predominantly due to lack of blinding (no placebo treatment in the control arm) or due to an inadequate method of treatment allocation/concealment. These studies were still included in the final analysis and sensitivity assessment was performed to assess the impact of bias on the outcomes.…”

Early Administration of Low-Dose Aspirin for the Prevention of Preterm and Term Preeclampsia: A Systematic Review and Meta-Analysis

“…Of these, only five studies on a combined total of 556 women were included in the final analysis because they fulfilled the three entry criteria: (1) treatment with aspirin or placebo initiated at or before 16 weeks of gestation, (2) information provided on preterm and term preeclampsia, and (3) judged for low-risk or unclear risk of bias. The control group received placebo in three of these studies and no treatment in two (table 1) [21,22,23,24,25]. …”