SHI Xiaoxia,BAI Yan,RONG Liting,et al.Efficacy and safety of different daily doses of aspirin in prevention of preeclampsia:a meta-analysis[J].ZHONGGUO YAOFANG,2025,36(21):2733-2737.
SHI Xiaoxia,BAI Yan,RONG Liting,et al.Efficacy and safety of different daily doses of aspirin in prevention of preeclampsia:a meta-analysis[J].ZHONGGUO YAOFANG,2025,36(21):2733-2737. DOI: 10.6039/j.issn.1001-0408.2025.21.20.
Efficacy and safety of different daily doses of aspirin in prevention of preeclampsia:a meta-analysis
To compare the efficacy and safety of different daily doses of aspirin in the prevention of preeclampsia (PE).
METHODS
2
The case-control studies and prospective randomized controlled trials on aspirin with daily dose ≥ 100 mg (trial group) vs. <100 mg (control group) in the prevention of PE were retrieved from PubMed, Medline, Embase, the Cochrane Library, CNKI, China Biomedical Literatue Database and Wanfang Data from base-building to January 2025. After literature screening, data extraction and quality evaluation, meta-analysis was performed by using RevMan 5.3 software.
RESULTS
2
A total of 11 literatures were included, involving 3 052 pregnant women. Meta-analysis showed the incidence of PE [RR=0.63, 95%CI (0.53,0.76),
, and intrauterine growth retardation [RR=0.73,95%CI (0.61,0.87),
P
=0.000 5
]
in trial groups were significantly lower than control group. The incidence of postpartum hemorrhage between the two groups had no statistically significant difference [RR=1.17, 95%CI (0.90,1.53),
P
=0.25
]
. Subgroup analysis showed that the incidence of PE in Chinese pregnant women taking 150 mg of aspirin was significantly higher than taking 100 mg of aspirin [RR=3.40, 95%CI (1.29, 8.93),
P
=0.01
]
; but there was no significant difference between the two groups in the incidences of postpartum hemorrhage, preterm birth (
P
>0.05).
CONCLUSIONS
2
Aspirin with daily dose ≥100 mg is more effective in preventing PE than daily dose <100 mg, with lower rates of gestational hypertension, preterm birth, and intrauterine growth retardation. It does not increase the risk of postpartum hemorrhage. For pregnant women in China, daily dose 100 mg of aspirin may be more effective in preventing PE than 150 mg.
ROBERGE S , BUJOLD E , NICOLAIDES K H . Aspirin for the prevention of preterm and term preeclampsia:systematic review and metaanalysis [J ] . Am J Obstet Gynecol , 2018 , 218 ( 3 ): 287 - 293.e1 .
CLUVER C , KUPKA E , HESSELMAN S , et al . Compa- ring aspirin 75 to 81 mg vs 150 to 162 mg for prevention of preterm preeclampsia:systematic review and meta-analysis:questionable quality and small study effects [J ] . Am J Obstet Gynecol MFM , 2023 , 5 ( 10 ): 101098 .
STANG A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses [J ] . Eur J Epidemiol , 2010 , 25 ( 9 ): 603 - 605 .
JADAD A R , MOORE R A , CARROLL D , et al . Asses- sing the quality of reports of randomized clinical trials:is blinding necessary? [J ] . Control Clin Trials , 1996 , 17 ( 1 ): 1 - 12 .
CHAMANI M , SHAHRABI S , MALMIR A , et al . Effect of aspirin dose on preeclampsia prevention and fetal-maternal complications:a randomized clinical trial [J ] . Jundishapur J Chronic Dis Care , 2021 , 11 ( 1 ): e114112 .
AMRO F H , BLACKWELL S C , PEDROZA C , et al . Aspirin 162 mg vs 81 mg for preeclampsia prophylaxis in high-risk obese individuals:a comparative effectiveness open-label randomized trial (ASPREO) [J ] . Am J Obstet Gynecol , 2025 , 232 ( 3 ): 315.e1 - 315.e8 .
AYYASH M , GOYERT G , GARCIA R , et al . Efficacy and safety of aspirin 162 mg for preeclampsia prophylaxis in high-risk patients [J ] . Am J Perinatol , 2024 , 41 ( Suppl. 1 ): e2410 - e2417 .
KASRAEIAN M , ASADI N , VAFAEI H , et al . The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women [J ] . J Perinat Med , 2022 , 50 ( 9 ): 1264 - 1270 .
KUMAR N , DAS V , AGARWAL A , et al . Pilot interventional study comparing fetomaternal outcomes of 150 mg versus 75 mg aspirin starting between 11 and 14 weeks of pregnancy in patients with high risk of preeclampsia:a randomized control trial [J ] . J Obstet Gynaecol India , 2020 , 70 ( 1 ): 23 - 29 .
SINHA N , SINGH S , AGARWAL M , et al . A randomized controlled study comparing the efficacy of 75 mg versus 150 mg aspirin for the prevention of preeclampsia in high-risk pregnant women [J ] . Cureus , 2023 , 15 ( 5 ): e39752 .
ZORZATO P , TORCIA E , CARLIN A , et al . Comparison of two aspirin doses for the prophylaxis of preeclampsia in twin pregnancy:a multicentre retrospective study with propensity score matching [J ] . Am J Obstet Gynecol , 2025 , 233 ( 1 ): 55.e1 - 55.e10 .
TAPP S , GUERBY P , GIRARD M , et al . A pilot rando- mized trial comparing the effects of 80 versus 160 mg of aspirin on midtrimester uterine artery pulsatility index in women with a history of preeclampsia [J ] . J Obstet Gynaecol Can , 2020 , 42 ( 12 ): 1498 - 1504 .
JONES PULLINS M E , BOGGESS K A . Aspirin dosage for preeclampsia prophylaxis:an argument for 162-mg dosing [J ] . Am J Obstet Gynecol MFM , 2025 , 7 ( Suppl.1 ): 101620 .
VINOGRADOV R , KAVANAGH O N , PALMER J , et al . A randomized crossover design study comparing the pharmacokinetics and pharmacodynamics of 2 single doses of oral aspirin (75 mg vs 150 mg) in pregnant women at risk of preeclampsia:implications on assessing aspirin response and patient adherence to therapy [J ] . Am J Obstet Gynecol , 2025 , 232 ( 5 ): 474.e1 - 474.e15 .
CARON N , RIVARD G É , MICHON N , et al . Low-dose ASA response using the PFA-100 in women with high-risk pregnancy [J ] . J Obstet Gynaecol Can , 2009 , 31 ( 11 ): 1022 - 1027 .
HENDERSON J T , WHITLOCK E P , O’CONNOR E , et al . Low-dose aspirin for prevention of morbidity and mortality from preeclampsia:a systematic evidence review for the U.S. preventive services task force [J ] . Ann Intern Med , 2014 , 160 ( 10 ): 695 - 703 .
FINNERAN M M , GONZALEZ-BROWN V M , SMITH D D , et al . Obesity and laboratory aspirin resistance in high-risk pregnant women treated with low-dose aspirin [J ] . Am J Obstet Gynecol , 2019 , 220 ( 4 ): 385.e1 - 385.e6 .
Immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy in the treatment of early-stage triple-negative breast cancer: a meta-analysis
Meta-analysis of the effects of SLCO1B1 gene polymorphisms on the efficacy and safety of rosuvastatin
Meta-analysis of efficacy and safety of cabozantinib in the treatment of advanced thyroid cancer
Meta-analysis of efficacy and safety of belimumab in the treatment of childhood-onset systemic lupus erythematosus
Efficacy and safety of new oral anticoagulants in patients with nonvalvular atrial fibrillation after left atrial appendage occlusion:a meta-analysis
Related Author
YANG Chunyan
ZHANG Shaohua
LI Rongkang
PENG Lei
ZHAO Li
BIE Jun
WANG Song
LIU Kefeng
Related Institution
Dept. of Oncology, Nanchong Hospital Affiliated to Beijing Anzhen Hospital, Capital Medical University (Nanchong Central Hospital), Sichuan Nanchong
Dept. of Urology, South China Hospital Affiliated to Shenzhen University
Dept. of Urology, the Second Hospital of Lanzhou University
Dept. of Pharmacy, the First Affiliated Hospital of Zhengzhou University
Dept. of Geriatrics, Lanzhou University Second Hospital