Low Dose Aspirin as Prophylaxis Reduces the Incidence of Preeclampsia in Women at High Risk - A Review

Abstract

Only pregnant women are susceptible to preeclampsia, a disorder that raises blood pressure and results in proteinuria, edema, or both. Although aspirin is not widely used due to safety and efficacy concerns, it is thought that high-risk pregnant women who take low doses of aspirin can avoid preeclampsia. Several clinical studies are been out on high-risk female patients to prevent preeclampsia with low dose aspirin (60-150 mg). Using a combination of keywords, the literature database that is available on multiple peer-reviewed national and international journals was searched electronically. Between 8 and 28 weeks of gestation, aspirin 100 mg or 150 mg was given together with a placebo to high-risk pregnant women in 11 RCTs. According to the existing research, preeclampsia and its associated foetal and maternal problems can be prevented or when high-risk pregnant women are given low-dose aspirin between 12 and 28 weeks of gestation, especially at night, the risk is decreased.

  • Page Number : 99-107
  • Keywords
    Preeclampsia, Hypertension, Pregnancy, Aspirin
  • DOI Number
    10.15415/jptrm.2021.92010
  • Authors
    • Riya M Cherian
    • Parminder Nain
    • Sanjana Mehta
    • Samrat Chauhan
    • Jaspreet Kaur

References

  • Al-Duqhaishi T, Al Rajaibi H, Al Waili K, Al Rasadi K, Nadar SK, Al Hashmi K. Antihypertensive drugs and perinatal outcomes in hypertensive women attending a specialized tertiary hospital. Oman Medical Journal. 2022 Mar;37(2):e354.
  • Ali MK, Amin ME, Amin AF, Abd El Aal DE. Evaluation of the effectiveness of low-dose aspirin and omega 3 in treatment of asymmetrically intrauterine growth restriction: A randomized clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017 Mar 1;210:231-5.
  • Aronow WS. Hypertensive disorders in pregnancy. Ann Transl Med 2017;5(12):266
  • Asefa F, Hunde A, Siraneh Y. Outcome of Hypertensive Disorders of Pregnancy and Associated Factors Among Pregnant Women Admitted to Jimma University Medical Center, Southwest Ethiopia. Ethiopian Journal of Reproductive Health. 2020 May 12;12(01):12-12.
  • Bello NA, Zhou H, Cheetham TC, Miller E, Getahun D, Fassett MJ, Reynolds K. Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes. JAMA network open. 2021 Mar 1;4(3):e213808-.
  • Bij de Weg JM, Abheiden CN, de Boer MA, de Groot C, de Vries JI. Patients’ perspective on aspirin during pregnancy: a survey. Hypertension in Pregnancy. 2020 Oct 1;39(4):371-8.
  • Bond RM, Phillips K, Ivy KN, Ogueri V, Parapid B, Miller SC, Ansong A. Cardiovascular Health of Black Women Before, During, and After Pregnancy: A Call to Action and Implications for Prevention. Current Cardiovascular Risk Reports. 2022 Jul 23:1-0.
  • Dutta S, Kumar S, Hyett J, Salomon C. Molecular targets of aspirin and prevention of preeclampsia and their potential association with circulating extracellular vesicles during pregnancy. International journal of molecular sciences. 2019 Sep 5;20(18):4370.
  • Fox R, Kitt J, Leeson P, et. al. Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring. J Clin Med. 2019;8(10):1625.
  • Guizani M, Valsamis J, Dutemeyer V, Kang X, Ceccotti V, Khalife J, Duiella SF, Blavier F, Faraca A, Cos T, Jani JC. First-trimester combined multimarker prospective study for the detection of pregnancies at a high risk of developing preeclampsia using the Fetal Medicine Foundation-algorithm. Fetal diagnosis and therapy. 2018;43:266-73.
  • Hermida RC, Ayala DE. Ambulatory blood pressure monitoring in special populations: During pregnancy. InBlood Pressure Monitoring in Cardiovascular Medicine and Therapeutics 2016 (pp. 253-276). Humana Press, Cham.
  • Hitti J, Sienas L, Walker S, Benedetti TJ, Easterling T. Contribution of hypertension to severe maternal morbidity. American journal of obstetrics and gynecology. 2018 Oct 1;219(4):405-e1.
  • Hladunewich MA. Chronic kidney disease and pregnancy. InSeminars in Nephrology 2017 Jul 1 (Vol. 37, No. 4, pp. 337-346). WB Saunders.
  • Jarvie JL, Metz TD, Davis MB, Ehrig JC, Kao DP. Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy. Heart. 2018 Jul 1;104(14):1187-94.
  • Khalil G, Hameed A. Preeclampsia: Pathophysiology and the Maternal-Fetal Risk. J Hypertens Manag2017; 3:024.
  • Lin L, Huai J, Li B, Zhu Y, Juan J, Zhang M, Cui S, Zhao X, Ma Y, Zhao Y, Mi Y. A randomized controlled trial of low-dose aspirin for the prevention of preeclampsia in women at high risk in China. American Journal of Obstetrics and Gynecology. 2022 Feb 1;226(2):251-e1.
  • Mone F, Mulcahy C, McParland P, Stanton A, Culliton M, Downey P, McCormack D, Tully E, Dicker P, Breathnach F, Malone FD. An open-label randomized-controlled trial of low dose aspirin with an early screening test for pre-eclampsia and growth restriction (TEST): Trial protocol. Contemporary Clinical Trials. 2016 Jul 1;49:143-8.
  • Mrema D, Lie RT, Ostbye T, et al. The association between pre pregnancy body mass index and risk of preeclampsia: a registry based study from Tanzania. BMC Pregnancy Childbirth 2018; 18 (56):1-8.
  • Purswani JM, Gala P, Dwarkanath P, et. al. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):231.
  • Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. American journal of obstetrics and gynecology. 2017 Feb 1;216(2):110-20.
  • Rolnik DL, Wright D, Poon LC, et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med. 2017;377(7):613‐22.
  • Scazzocchio E, Oros D, Diaz D, Ramirez JC, Ricart M, Meler E, González de Agüero R, Gratacos E, Figueras F. Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks: a randomized controlled study.
  • Scazzocchio, E., Oros, D., Diaz, D., Ramirez, J.C., Ricart, M., Meler, E., González de Agüero, R., Gratacos, E. and Figueras, F., 2017. Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks: a randomized controlled study.
  • Siddiqui MA, Mittal PK, Little BP, Miller FH, Akduman EI, Ali K, Sartaj S, Moreno CC. Secondary hypertension and complications: diagnosis and role of imaging. Radiographics. 2019 Jul;39(4):1036-55.
  • Sutton EF, Hauspurg A, Lin LN, Powers RW, Catov JM. Maternal outcomes associated with lower-range stage 1 hypertension. Obstetrics and gynecology. 2018 Oct;132(4):843.
  • Tolcher MC, Sangi-Haghpeykar H, Mendez-Figueroa H, Aagaard KM. The timing of aspirin administration in pregnancy is important to prevent preeclampsia. American Journal of Obstetrics & Gynecology MFM. 2021 May 1;3(3).
  • Villa, P.M., Kajantie, E., Räikkönen, K., Pesonen, A.K., Hämäläinen, E. and Vainio, M., 2020. Aspirin in the Prevention of Pre-Eclampsia in High-Risk Women: A Randomized Placebo-Controlled PREDO Trial and a Meta-Analysis of Randomized Trials. BJOG: An International Journal of Obstetrics and Gynecology, 120, 64-74.
  • Villa, Zhou F, Deng C, et al. Low-dose aspirin for preventing preeclampsia and its complications: a meta-analysis. J Clin Hypertens. (Greenwich) 2015; 17:567–573.
  • Wallace JM, Bhattacharya S, Campbell DM, Horgan GW. Inter-pregnancy weight change and the risk of recurrent pregnancy complications. PLoS One. 2016 May 4;11(5):e0154812.

  • Published Date : 2021-11-08