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.
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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)
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Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
- Teratogens
- Aspirin
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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)
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