Preeclampsia prevention: lessons from the low-dose aspirin therapy trials.
The ability of low-dose aspirin therapy to prevent preeclampsia is controversial. The 19 randomized, placebo-controlled trials of low-dose aspirin therapy reported in the literature were categorized according to the risk factors of the women studied-nulliparity, underlying medical illness, poor obstetric history, and multiple gestation. Low-dose aspirin therapy reduced the incidences of preeclampsia among women with poor obstetric histories and among high-risk nulliparous women but was ineffective among women with underlying medical illness. It was marginally effective among low-risk nulliparous women, and benefits for women with multiple gestations are unclear. More research is needed to better identify high-risk nulliparous women who might benefit from the use of low-dose aspirin therapy and to define potential benefits for women with multiple gestations. The differential effects of low-dose aspirin therapy in the various risk groups are probably a result of varying roles in the groups of abnormal arachidonic acid metabolism in mediating preeclampsia. It is premature to abandon the use of low-dose aspirin therapy for preeclampsia prevention.
Heyborne
K D
KD
Division of Maternal-Fetal Medicine, Swedish Medical Center, Englewood, CO 80110, USA.
D001241:Aspirin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016239:MEDLINE; D010919:Placebos; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors
D010919:Placebos; D001241:Aspirin