Low-Dose Aspirin for the Prevention of Preeclampsia in High-Risk Women: A Systematic Review and Meta-Analysis

Abstract

Introduction: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Low-dose aspirin has been proposed as a preventive agent. This review aims to evaluate the efficacy of low-dose aspirin in preventing preeclampsia and its complications in high-risk pregnancies.

Methods: A comprehensive search of MEDLINE, Embase, and CENTRAL was conducted for randomized controlled trials (RCTs). We included studies comparing low-dose aspirin (75-162 mg/day) initiated before 20 weeks' gestation to placebo or no treatment in high-risk women. The primary outcome was the incidence of preeclampsia.

Results: The meta-analysis included 35 RCTs. Low-dose aspirin was associated with a statistically significant reduction in the risk of developing preeclampsia. It also significantly reduced the risks of severe preeclampsia, fetal growth restriction, and perinatal death.

Discussion: The prophylactic use of low-dose aspirin is a simple and effective intervention. The benefit is greatest when therapy is initiated early in pregnancy. Identifying high-risk women through proper screening is crucial for targeted prevention.

Conclusion: Low-dose aspirin is an effective therapy for reducing the risk of preeclampsia and its adverse outcomes in high-risk pregnancies.