Benefits of Low-Dose Aspirin During Pregnancy: A Systematic Review
Abstract
Abstract: Low-dose aspirin therapy (LDA) is reported to give good results on the outcome of pregnancy. This systematic review study aims to find out in what cases the role of LDA can be given, the amount of dose and duration of administration and the final results of various studies that have been conducted. Researchers used a systematic literature study with the help of Publish or Perish, Mendeley and Microsoft Excel applications in a literature search from Google Scholar with the keyword low dose aspirin related to pregnancy. Of the 200 articles taken, after conducting a systematic assessment, 21 articles were included in the inclusion criteria that discussed 4 topics, namely pre-eclampsia, current pregnancy loss, healthy pregnancy and inflammatory cases in pregnancy. From the results of the review, it can be concluded that low-dose aspirin can be used and is beneficial in preventing and treating some complications in pregnancy. Its administration can be given before conception until gestational age reaches 36 weeks with a dose range of 50 mg to 150 mg per day.
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Andræ F, Abbott D, Stridsklev S, et al. Sustained maternal hyperandrogenism during Pcos pregnancy was reduced by metformin in non-obese women carrying a male fetus. J Clin Endocrinol Metab. 2020;105(12):3762-3770. doi:10.1210/clinem/dgaa605
Molin J, Vanky E, Løvvik TS, Dehlin E, Bixo M. Gestational weight gain, appetite-regulating hormones, and metformin treatment in polycystic ovary syndrome: A longitudinal, placebo-controlled study. BJOG An Int J Obstet Gynaecol. 2022;129(7):1112-1121. doi:10.1111/1471-0528.17042
Ju Y, Feng Y, Yang Y, et al. Combining curcumin and aspirin ameliorates preeclampsia-like symptoms by inhibiting the placental TLR4/NF-κB signalling pathway in rats. J Obstet Gynaecol Res. 2023;49(1):128-140. doi:10.1111/jog.15473
Thomas KC, Chon AH, Mestman J, Nguyen CT, Paulson RJ, Johnson B. A case report of severe hypothyroidism in pregnancy complicated by ovarian torsion: The role of medical treatment. Ann Thyroid. 2021;6. doi:10.21037/aot-20-59
Vinogradov R, Smith VJ, Robson SC, Araujo-Soares V. Aspirin non-adherence in pregnant women at risk of preeclampsia (ANA): a qualitative study. Heal Psychol Behav Med. 2021;9(1):681-700. doi:10.1080/21642850.2021.1951273
Wang T, Kang X, Zhao A, He L, Liu Z, Liu F. Low-dose aspirin improves endometrial receptivity in the mid-luteal phase in unexplained recurrent pregnancy loss. Int J Gynecol Obstet. 2020;150(1):77-82. doi:10.1002/ijgo.13160
Dutta S, Kumar S, Hyett J, Salomon C. Molecular targets of aspirin and prevention of preeclampsia and their potential association with circulating extracellular vesicles during pregnancy. Int J Mol Sci. 2019;20(18). doi:10.3390/ijms20184370
Hoffman MK, Goudar SS, Kodkany BS, et al. Low-Dose Aspirin for the Prevention of Preterm Delivery in Nulliparous Women with a Singleton Pregnancy (ASPIRIN): A Randomized, Double-blind, Placebo-Controlled Trial. Obstet Gynecol Surv. 2020;75(6):325-327. doi:10.1097/OGX.0000000000000814
Lu C, Liu Y, Jiang HL. Aspirin or heparin or both in the treatment of recurrent spontaneous abortion in women with antiphospholipid antibody syndrome: a meta-analysis of randomized controlled trials. J Matern Neonatal Med. 2019;32(8):1299-1311. doi:10.1080/14767058.2017.1404979
Lin L, Li G, Zhang W, Wang YL, Yang H. Low-dose aspirin reduces hypoxia-induced sFlt1 release via the JNK/AP-1 pathway in human trophoblast and endothelial cells. J Cell Physiol. 2019;234(10):18928-18941. doi:10.1002/jcp.28533
Gu W, Lin J, Hou YY, et al. Effects of low-dose aspirin on the prevention of preeclampsia and pregnancy outcomes: A randomized controlled trial from Shanghai, China. Eur J Obstet Gynecol Reprod Biol. 2020;248:156-163. doi:10.1016/j.ejogrb.2020.03.038
Finneran MM, Gonzalez-Brown VM, Smith DD, Landon MB, Rood KM. Obesity and laboratory aspirin resistance in high-risk pregnant women treated with low-dose aspirin. Am J Obstet Gynecol. 2019;220(4):385.e1-385.e6. doi:10.1016/j.ajog.2019.01.222
Kalafat E, Shirazi A, Thilaganathan B, Khalil A. The role of aspirin in the prevention of preeclampsia in twin pregnancies: does the dose matter? Am J Obstet Gynecol. 2020;223(3):457-458. doi:10.1016/j.ajog.2020.03.005
Madani T, Ahmadi F, Jahangiri N, Bahmanabadi A, Bagheri Lankarani N. Does low-dose aspirin improve pregnancy rate in women undergoing frozen-thawed embryo transfer cycle? A pilot double-blind, randomized placebo-controlled trial. J Obstet Gynaecol Res. 2019;45(1):156-163. doi:10.1111/jog.13802
Naimi AI, Perkins NJ, Sjaarda LA, et al. The effect of preconception-initiated low-dose aspirin on human chorionic gonadotropin-detected pregnancy, pregnancy loss, and live birth: Per protocol analysis of a randomized trial. Ann Intern Med. 2021;174(5):595-601. doi:10.7326/M20-0469
Zvanca ME, Bot M, Radu D, Radu N, Petca A. Impact of early supplementation with low-dose aspirin on functional first trimester parameters in low-risk pregnancies. J Matern Neonatal Med. 2019;32(4):604-609. doi:10.1080/14767058.2017.1387532
Karadağ C, Akar B, Gönenç G, Aslancan R, Yılmaz N, Çalışkan E. Aspirin, low molecular weight heparin, or both in preventing pregnancy complications in women with recurrent pregnancy loss and factor V Leiden mutation. J Matern Neonatal Med. 2020;33(11):1934-1939. doi:10.1080/14767058.2019.1671348
van Montfort P, Scheepers HCJ, van Dooren IMA, et al. Low-dose-aspirin usage among women with an increased preeclampsia risk: A prospective cohort study. Acta Obstet Gynecol Scand. 2020;99(7):875-883. doi:10.1111/aogs.13808
Huai J, Lin L, Juan J, et al. Preventive effect of aspirin on preeclampsia in high-risk pregnant women with stage 1 hypertension. J Clin Hypertens. 2021;23(5):1060-1067. doi:10.1111/jch.14149
Levine LD, Holland TL, Kim K, Sjaarda LA, Mumford SL, Schisterman EF. The role of aspirin and inflammation on reproduction: The EAGeR trial1. Can J Physiol Pharmacol. 2019;97(3):187-192. doi:10.1139/cjpp-2018-0368
Wang M, Zhang P, Yu S, et al. Heparin and aspirin combination therapy restore T-cell phenotype in pregnant patients with antiphospholipid syndrome-related recurrent pregnancy loss. Clin Immunol. 2019;208. doi:10.1016/j.clim.2019.108259
Walsh SW, Reep DT, Alam SMK, et al. Placental Production of Eicosanoids and Sphingolipids in Women Who Developed Preeclampsia on Low-Dose Aspirin. Reprod Sci. 2020;27(12):2158-2169. doi:10.1007/s43032-020-00234-2
Wheeler SM, Myers SO, Swamy GK, Myers ER. Estimated Prevalence of Risk Factors for Preeclampsia among Individuals Giving Birth in the US in 2019. JAMA Netw Open. 2022;5(1). doi:10.1001/jamanetworkopen.2021.42343
Theilen LH, Campbell HD, Mumford SL, et al. Platelet activation and placenta-mediated adverse pregnancy outcomes: an ancillary study to the Effects of Aspirin in Gestation and Reproduction trial. Am J Obstet Gynecol. 2020;223(5):741.e1-741.e12. doi:10.1016/j.ajog.2020.05.026
Wang M, Chen S, He Y, Zhao M, Yang H, Chen Q. Low-dose aspirin for the prevention of severe preeclampsia in patients with chronic kidney disease: a retrospective study: This is the study for kidney and pregnancy. J Nephrol. 2021;34(5):1631-1639. doi:10.1007/s40620-021-01049-3
Li X, Milosavljevic A, Elsea SH, et al. Effective Aspirin Treatment of Women at Risk for Preeclampsia Delays the Metabolic Clock of Gestation. Hypertension. Published online 2021:1398-1410. doi:10.1161/HYPERTENSIONAHA.121.17448
Sun S, Li C, Kou X, Chen C, Guo F, Zhao A. Association of prednisone and antinuclear antibodies with pregnancy outcomes in women with unexplained recurrent pregnancy loss. Int J Gynecol Obstet. 2021;154(3):492-499. doi:10.1002/ijgo.13556
Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia—Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;76(14):1690-1702. doi:10.1016/j.jacc.2020.08.014
Xue Y, Gao S, Gou J, et al. Platinum-based chemotherapy in combination with PD-1/PD-L1 inhibitors: preclinical and clinical studies and mechanism of action. Expert Opin Drug Deliv. 2021;18(2):187-203. doi:10.1080/17425247.2021.1825376
Shen DS, Yang YJ, Kong XJ, et al. Aspirin eugenol ester inhibits agonist-induced platelet aggregation in vitro by regulating PI3K/Akt, MAPK and Sirt 1/CD40L pathways. Eur J Pharmacol. 2019;852:1-13. doi:10.1016/j.ejphar.2019.02.032
Harrison P, Bethel MA, Kennedy I, Dinsdale R, Coleman R, Holman RR. Comparison of nine platelet function tests used to determine responses to different aspirin dosages in people with type 2 diabetes. Platelets. 2019;30(4):521-529. doi:10.1080/09537104.2018.1478402
bij de Weg JM, Abheiden CNH, Fuijkschot WW, et al. Resistance of aspirin during and after pregnancy: A longitudinal cohort study. Pregnancy Hypertens. 2020;19:25-30. doi:10.1016/j.preghy.2019.11.008
Danjuma MI, Al-Khulaifi A, Elshafei MN. The effect of low-dose aspirin on platelet function during pregnancy compared to placebo: An explorative study. A letter to the Editor. Eur J Obstet Gynecol Reprod Biol. 2023;280:198-199. doi:10.1016/j.ejogrb.2022.12.013
Gee SE, Ma’ayeh M, Kniss D, Landon MB, Gabbe SG, Rood KM. Glycemic Control and Aspirin Resistance in Patients Taking Low-Dose Aspirin for Pre-eclampsia Prevention. Am J Perinatol. 2022;39(4):349-353. doi:10.1055/s-0041-1740250
Roubey RAS. Antiphospholipid Syndrome. Autoimmune Dis. Published online 2006:381-399. doi:10.1016/B978-012595961-2/50033-0
Dimitriadis E. Recurrent pregnancy loss. Nat Rev Dis Prim. 2020;6(1). doi:10.1038/s41572-020-00228-z
Zhang X, Guo F, Wang Q, Bai W, Zhao A. Low-dose aspirin improves blood perfusion of the endometrium of unexplained recurrent biochemical pregnancy loss. Int J Gynecol Obstet. 2022;157(2):418-423. doi:10.1002/ijgo.13838
Crescente M, Menke L, Chan M V., Armstrong PC, Warner TD. Eicosanoids in platelets and the effect of their modulation by aspirin in the cardiovascular system (and beyond). Br J Pharmacol. 2019;176(8):988-999. doi:10.1111/bph.14196
Parker WAE, Orme RC, Hanson J, et al. Very-low-dose twice-daily aspirin maintains platelet inhibition and improves haemostasis during dual-antiplatelet therapy for acute coronary syndrome. Platelets. 2019;30(2):148-157. doi:10.1080/09537104.2019.1572880
Grandone E, Piazza G. Thrombophilia, Inflammation, and Recurrent Pregnancy Loss: A Case-Based Review. Semin Reprod Med. 2021;39(1-2):62-68. doi:10.1055/s-0041-1731827
Alijotas-Reig J, Esteve-Valverde E, Llurba E, Gris JM. Treatment of refractory poor aPL-related obstetric outcomes with TNF-alpha blockers: Maternal-fetal outcomes in a series of 18 cases. Semin Arthritis Rheum. 2019;49(2):314-318. doi:10.1016/j.semarthrit.2019.02.006
Benito-Garcia F, Pires I, Lima J. Aspirin desensitization: Implications for acetylsalicylic acid-sensitive pregnant women. Med. 2021;57(4). doi:10.3390/medicina57040390
Ruan LY, Lai ZZ, Yang HL, et al. The application of aspirin in pregnancy-related complications. Reprod Dev Med. 2020;4(3):184-190. doi:10.4103/2096-2924.296548
Petri M. Pregnancy and Systemic Lupus Erythematosus. Best Pract Res Clin Obstet Gynaecol. 2020;64:24-30. doi:10.1016/j.bpobgyn.2019.09.002
Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, et al. Bleeding and antithrombotic therapy during pregnancy in women with poor aPL-related obstetric outcomes: A survey of 1075 cases from EUROAPS registry∗. Eur J Anaesthesiol. 2021;38(9):916-922. doi:10.1097/EJA.0000000000001484
Lefkou E, Varoudi K, Pombo J, et al. Triple therapy with pravastatin, low molecular weight heparin and low-dose aspirin improves placental haemodynamics and pregnancy outcomes in obstetric antiphospholipid syndrome in mice and women through a nitric oxide-dependent mechanism. Biochem Pharmacol. 2020;182. doi:10.1016/j.bcp.2020.114217
Zhang Y, Shen F, Yang W, Wang J, Zhou J, Chen Y. Effects of low-molecular-weight heparin and aspirin in recurrent pre-eclampsia: A stratified cohort study. Int J Gynecol Obstet. 2021;154(2):337-342. doi:10.1002/ijgo.13535
Shi T, Gu ZD, Diao QZ. Meta-analysis on aspirin combined with low-molecular-weight heparin for improving the live birth rate in patients with antiphospholipid syndrome and its correlation with d -dimer levels. Med (United States). 2021;100(25):E26264. doi:10.1097/MD.0000000000026264
Haa BE, O’Hara NN, Manso TT, et al. Aspirin versus low-molecular-weight heparin for venous thromboembolism prophylaxis in orthopaedic trauma patients: A patient-centred randomized controlled trial. PLoS One. 2020;15(8 August). doi:10.1371/journal.pone.0235628
Gholizadeh Shamasbi S, Dehgan P, Mohammad-Alizadeh Charandabi S, Aliasgarzadeh A, Mirghafourvand M. The effect of resistant dextrin as a prebiotic on metabolic parameters and androgen level in women with polycystic ovarian syndrome: a randomized, triple-blind, controlled, clinical trial. Eur J Nutr. 2019;58(2):629-640. doi:10.1007/s00394-018-1648-7
DOI: https://doi.org/10.30596/bf.v8i2.14659
DOI (PDF): https://doi.org/10.30596/bf.v8i2.14659.g9802
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JURNAL BULETIN FARMATERA
Gedung Kampus 1 Universitas Muhammadiyah Sumatera Utara (UMSU) Lantai II, Laboratorium Farmakologi dan Terapi Fakultas Kedokteran UMSU Jalan Gedung Arca No. 53 Medan Sumatera Utara Indonesia, Kode Pos 20217.
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