The Role of Aspirin Dose on the Prevention of Preeclampsia and Fetal Growth Restriction: Systematic Review and Meta-Analysis

Roberge, Stéphanie; Nicolaides, Kypros; Demers, Suzanne; Hyett, Jonathan; Chaillet, Nils; Bujold, Emmanuel

doi:10.1097/01.aoa.0000511998.98893.df

Cited by 41 publications

(58 citation statements)

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“…for the prevention of preeclampsia if initiated after 16 weeks gestation (Roberge et al, 2017). A careful and thorough review of personal and family history will identify women who are most at risk for preeclampsia and for whom low-dose aspirin therapy would provide the most benefit.…”

Section: Resultsmentioning

confidence: 99%

“…Researchers have documented that the use of low-dose aspirin among pregnant women at risk for preeclampsia has multiple benefits, including reduced risk of preeclampsia, preterm birth, and IUGR (Henderson, et al, 2014;LeFevre, 2014;Roberge et al, 2017;Rolnik et al, 2017). During clinical trials, researchers have used doses of aspirin ranging from 60 mg to 150 mg; however, there is no consensus on whether any one dose in that range is ideal.…”

Section: Implications For Nursing Practicementioning

confidence: 99%

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Low-Dose Aspirin for the Prevention of Preeclampsia

Fantasia¹

2018

Nursing for Women's Health

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Preeclampsia is a hypertensive disorder specific to pregnancy that remains a significant cause of maternal and neonatal morbidity and mortality. Identification of women who are most at risk for preeclampsia is imprecise. Because of the potential negative health consequences of preeclampsia for women and newborns and the lack of effective screening mechanisms preventing preeclampsia is an important component of prenatal care. Researchers have documented that low-dose aspirin, taken daily after the first trimester, can decrease the development of preeclampsia and reduce the incidence of preterm birth and birth of small-for-gestational-age infants. This column includes an overview of low-dose aspirin in pregnancy and a review of current recommendations from leading national organizations.

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Section: Resultsmentioning

confidence: 99%

Section: Implications For Nursing Practicementioning

confidence: 99%

Low-Dose Aspirin for the Prevention of Preeclampsia

Fantasia¹

2018

Nursing for Women's Health

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“…Lowdose aspirin is considered a reasonable preventive strategy and used worldwide for preeclampsia among highrisk groups because of its excellent maternal and fetal safety profile in pregnancy. 3 Several meta analyses showed that lowdose aspirin use in early pregnancy led to significant reductions in the risk of preeclampsia; in one 2017 metaanalysis, 3 aspirin initiated at 16 weeks or earlier reduced the risk of preeclampsia (risk ratio 0•57, 95% CI 0•43-0•75). Additonally, because lowdose aspirin is usually initiated after conception, the use of lowdose aspirin could not be randomised and, thus, might have caused a bias in the results of Hofmeyr and colleagues' study.…”

Section: Prepregnancy Calcium Supplementation and Pre-eclampsiamentioning

confidence: 99%

Prepregnancy calcium supplementation and pre-eclampsia

et al. 2019

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“…The most effective ASA dose in preventing cardiovascular events seems to be 75-150 mg, which has similar efficacy as doses up to 1500 mg ASA daily (Mansour et al, 2009). A systematic review and meta-analysis of the outcomes moderate and severe preeclampsia and intrauterine growth retardation (Roberge et al, 2016) found that treatment with 75-150 mg ASA daily was associated with a reduction of all three studied outcomes. Individualized dosage of ASA after platelet function testing has been found to be effective in preventing preeclampsia in high-risk women (Rey et al, 2011).…”

Section: Paper IIImentioning

confidence: 99%

Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

et al. 2018

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Increased platelet activation is involved in obstetric complications such as preeclampsia and intrauterine growth retardation. It is of interest to study platelet aggregation during pregnancy, since increased aggregation theoretically could be a mechanism associated with placenta-mediated complications, which possibly could be prevented by drugs inhibiting platelet aggregation. There are, however, few robust studies describing platelet aggregation during normal pregnancy. The present longitudinal study was performed in order to study platelet aggregation during normal pregnancy resulting in a healthy child, during the puerperium and in nonpregnant, fertile women. Healthy, nonsmoking, pregnant women (n = 104), aged under 39 years and with BMI < 35, were followed during pregnancy and postpartum. Twenty-seven nonpregnant, non-puerperal, fertile women were studied for comparison. Platelet aggregation was determined with multiple electrode impedance aggregometry and analyzed at inclusion, 4 times during pregnancy and after at least 3 months postpartum. Platelet aggregation postpartum was compared with gestational weeks 8-15 and 37-40, respectively, and with nonpregnant, fertile women. Hemoglobin, leucocyte count, platelet count, prothrombin time, and activated partial thromboplastin time were determined at inclusion in order to verify normal hemostasis. Activation of platelets by arachidonic acid, adenosine diphosphate (ADP), and thrombin receptor activating peptide (trap-6) resulted in less aggregation during pregnancy, compared with postpartum (p < 0.03-< 0.001). Platelet aggregation following activation by collagen was unchanged. A minor increase in aggregation as pregnancy continued was found related to ADP (p < 0.021). Positive correlations were found between platelet counts and platelet aggregation. Postpartum platelet aggregation after activation with arachidonic acid, collagen, and trap-6 was lower than in the non-puerperal fertile state. Other hemostatic analyses were normal. In conclusion, there is a minor decrease in platelet aggregation after activation with arachidonic acid, trap-6, and ADP, measured with multiple electrode impedance aggregometry during normal pregnancy resulting in healthy babies, compared with the postpartum period. The small changes in platelet aggregation may be a consequence of a minor decrease in platelet count and probably lack clinical significance under normal conditions. Interindividual variations at certain time-points are substantial, which limits the usefulness of the multiple electrode impedance aggregometry for determining minor changes in platelet function.

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The Role of Aspirin Dose on the Prevention of Preeclampsia and Fetal Growth Restriction: Systematic Review and Meta-Analysis

Cited by 41 publications

References 0 publications

Low-Dose Aspirin for the Prevention of Preeclampsia

Low-Dose Aspirin for the Prevention of Preeclampsia

Prepregnancy calcium supplementation and pre-eclampsia

Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

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