OBJECTIVETo estimate the effect of early intervention with aspirin for prevention of preeclampsia in high-risk women.

METHODSA systematic review and meta-analysis were performed based on the principles and methods of Cochrane systematic reviews. Electronic databases were searched for randomized trials comparing aspirin with either placebo or no aspirin. Studies were included when meeting the inclusion criteria that the participants were pregnant women at a high risk of preeclampsia and started aspirin therapy at 16 gestational weeks or earlier, which were assessed by two independent reviewers. Meta-analysis was conducted using Review Manger 5.3 software.

RESULTSA total of 5 studies involving 860 participants were included in the final analysis. In the high-risk women, early use of aspirin showed an OR of 0.35 (95% CI 0.17-0.75) for preventing pregnancy-induced hypertension (PIH), 0.75 (95% CI 0.47-0.98) for preeclampsia, 0.53 (95% CI 0.29-0.98) for intrauterine growth retardation, and 0.20 (95% CI 0.08-0.48) for preterm birth; the average birth weight in aspirin intervention group was 107.15 g (95% CI 76.13-138.18, P<0.001) more than that in the control group.

CONCLUSIONIn high-risk pregnancies, early aspirin intervention starting before 16 weeks of gestation can prevent PIH, preeclampsia, IUGR, and preterm birth and help to increase the birth weight.