Low-Dose Aspirin for Pre-Eclampsia Prevention: A Systematic Review and Meta-Analysis

Pre-eclampsia is a leading cause of maternal and perinatal morbidity, and low-dose aspirin is the most widely recommended preventive drug. This narrative review, which reports no new data, summarises what published randomised trials and meta-analyses show about aspirin for pre-eclampsia prevention, including mechanism, dose, timing, risk selection and safety. Syntheses consistently report a modest overall reduction in pre-eclampsia, with larger effects for preterm disease when treatment starts early in pregnancy at doses of about 100 mg or more in women at increased risk. Serious maternal bleeding has not been shown to increase. Uncertainties remain about optimal dose, duration, adherence and use in low-resource settings, and heterogeneity limits pooled estimates.