Preventing preeclampsia and its fetal complications with low-dose aspirin in East Asians and non-East Asians:A systematic review and meta-analysis

Hypertens Pregnancy. 2016 Aug;35(3):426-35. doi: 10.1080/10641955.2016.1178772. Epub 2016 Jun 17.

Abstract

Background: Low-dose aspirin can reduce the incidence of preeclampsia and intrauterine growth restriction (IUGR). However, the effects of ethnicity upon low-dose aspirin's efficacy has not been analyzed. Here, we comparatively evaluated the efficacy of low-dose aspirin in preventing preeclampsia and related fetal complications in East Asian and non-East Asian pregnant women at risk for preeclampsia.

Methods: Several databases were searched for randomized controlled trials (RCTs) comparing low-dose aspirin with either placebo or no treatment in pregnant women at risk for preeclampsia. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for preeclampsia and related fetal outcomes were tabulated.

Results: Low-dose aspirin significantly reduced preeclampsia risk in both East Asians (OR = 0.20, 95% CI: 0.11-0.35) and non-East Asians (OR = 0.84, 95% CI: 0.77-0.92). Low-dose aspirin significantly reduced IUGR risk in East Asians (OR = 0.36, 95% CI: 0.20-0.67) but not in non-East Asians (OR = 0.85, 95% CI: 0.41-1.77). Low-dose aspirin did not significantly reduce the risk of cesarean section in either East Asians (OR = 0.67, 95% CI: 0.14-3.22) or non-East Asians (OR = 1.01, 95% CI: 0.86-1.19).

Conclusions: Low-dose aspirin is effective in reducing preeclampsia risk in both East Asians and non-East Asians and has differential effects in East Asians and non-East Asians with respect to IUGR.

Keywords: Acetylsalicylic acid; Asian; IUGR; aspirin; intrauterine growth restriction; preeclampsia.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Asian People
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use*
  • Female
  • Fetal Growth Retardation / ethnology
  • Fetal Growth Retardation / prevention & control*
  • Humans
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Pre-Eclampsia / ethnology
  • Pre-Eclampsia / prevention & control*
  • Pregnancy

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin