What question did this study set out to answer?

To assess whether initiating low-dose aspirin before 17 weeks' gestation prevents preeclampsia and small-for-gestational-age neonates using data from large randomized controlled trials.

February 23, 2016American Journal of Perinatology

Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials

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Why the study?

Does low-dose aspirin started before 17 weeks' gestation prevent preeclampsia and small-for-gestational-age neonates in pregnant women?

Population

11,949 pregnant women from 3 large RCTs, including 3,293 recruited before 17 weeks' gestation.

Comparison

Low-dose aspirin started before 17 weeks'… vs Placebo

Design

Meta-analysis

Authors

SRStéphanie RobergeUniversité Laval BSBaha M. SibaiRutgers, The State University of New Jersey AMAffette McCaw‐BinnsUniversity of the West Indies System

Discussion

Member takes

Implication

60 mg aspirin before 17 weeks confers no preeclampsia or SGA prevention benefit; challenges assumptions that earlier initiation improves outcomes.

Key Points

To assess whether initiating low-dose aspirin before 17 weeks' gestation prevents preeclampsia and small-for-gestational-age neonates using data from large randomized controlled trials.
Meta-analysis of randomized controlled trials with >350 participants comparing aspirin to placebo during pregnancy, stratifying data by gestational age at trial entry (<17 vs. ≥17 weeks).
Included individual trial data from three eligible trials totaling 11,949 participants, with 3,293 recruited before 17 weeks' gestation.
Low-dose aspirin (60 mg) started before 17 weeks did not reduce preeclampsia (RR: 0.93; 95% CI: 0.75-1.15) or severe preeclampsia (RR: 0.96; 95% CI: 0.71-1.28).
Early aspirin initiation did not decrease small-for-gestational-age neonates (RR: 0.84; 95% CI: 0.56-1.26), with outcomes showing no significant difference compared to initiation at or after 17 weeks' gestation.

Structured PICO

Does low-dose aspirin started before 17 weeks' gestation prevent preeclampsia and small-for-gestational-age neonates in pregnant women?

Population

11,949 pregnant women from 3 large RCTs (>350 participants), including 3,293 recruited before 17 weeks' gestation.

Intervention

Low-dose aspirin (60 mg daily) started before 17 weeks' gestation

Comparator

Placebo

Outcome

Preeclampsiahard clinical

Data from large randomized trials do not support greater benefits of low-dose aspirin (60 mg daily) when started before 17 weeks' gestation for the prevention of preeclampsia or small-for-gestational-age neonates.

Limitations

Data obtained for only three (50%) of the six eligible trials

Cite This Study

Roberge et al. (2016) studied this question.

synapsesocial.com/papers/69d5722775589c71d767e562 https://doi.org/10.1055/s-0036-1572495

Topics

Dual antiplatelet therapy

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Implication

60 mg aspirin before 17 weeks confers no preeclampsia or SGA prevention benefit; challenges assumptions that earlier initiation improves outcomes.

Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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Topics

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