Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis.

Abstract

BACKGROUND:

We assessed the effects and safety of aspirin treatment during pregnancy on fetal and neonatal outcomes.

METHODS:

We searched MEDLINE (1966-2001), EMBASE (1980-2000), TOXLINE (1994-2000), EB M Cochrane Database of Systematic Reviews (1991-2000), Reproductive Toxicology (2001), teratology texts, and bibliographies of all the included studies. We looked for published randomized controlled studies reporting aspirin treatment to improve outcomes of moderate- and high-risk pregnancies. The key words used to search for articles about exposure to aspirin were salicylic acid, pregnancy, and pregnancy complications; key words used to search for outcome were neonatal diseases and abnormalities. Based on our search strategy, 1904 citations were identified; their titles and abstracts were reviewed by one reviewer. Of these citations, 182 papers were selected for detailed review. Two reviewers independently determined whether a study should be included in the final analysis. In cases of disagreement, the decision was based on the assessment of a third reviewer.

RESULTS:

Data were extracted independently by each reviewer. We calculated the pooled relative risk (RR) or weighted mean difference and 95% confidence intervals (CI), assuming a random-effect model. Thirty-eight studies met the inclusion criteria. The risk for miscarriage did not differ between women treated with aspirin andplacebo (seven studies; RR, 0.92; 95% CI, 0.71-119). Women who took aspirin had a significantly lower risk of preterm delivery than did those treated with placebo (22 studies; RR, 0.92; 95% CI, 0.86-0.98). There was no significant difference in perinatal mortality (20 studies; RR, 0.92; 95% CI, 0.81-1.05) and in the rate of small-for-gestational-age infants (12 studies; RR, 0.96; 95% CI, 0.87-1.07) among offspring of mothers treated with aspirin and those of mothers treated with a placebo.

CONCLUSION:

For women with moderate- and high-risk pregnancies, aspirin treatment seemed to have a small but significant effect on reducing the rate of preterm deliveries, but did not reduce the rate of perinatal death.

• Authors: Eran Kozer, Adriana Moldovan Costei, Rada Boskovic, Irena Nulman, Shekoufeh Nikfar, Gideon Koren
• Journal: Birth defects research. Part B, Developmental and reproductive toxicology (Birth Defects Res B Dev Reprod Toxicol) Vol. 68 Issue 1 Pg. 70-84 (Feb 2003) ISSN: 1542-9733 [Print] United States
• PMID: 12852485 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Teratogens
• Aspirin

Topics

• Abnormalities, Drug-Induced (epidemiology, etiology)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Aspirin (adverse effects)
• Birth Weight
• Female
• Fetal Death (epidemiology)
• Humans
• Infant Mortality
• Infant, Newborn
• Infant, Small for Gestational Age
• Obstetric Labor, Premature (epidemiology)
• Pregnancy
• Pregnancy Complications (epidemiology)
• Pregnancy Outcome (epidemiology)
• Randomized Controlled Trials as Topic
• Teratogens (toxicity)