Efficacy of aspirin for prevention of preeclampsia in twin pregnancy: A meta‐analysis

Abstract

Abstract Background Aspirin has been proven to be effective in preventing preeclampsia (PE) in singleton pregnancies. However, the use of aspirin for women with twin pregnancies is still debatable. The purpose of our meta‐analysis is to evaluate the effectiveness of aspirin for preventing preeclampsia in twin pregnancies. Methods We searched the following databases: PubMed, Scopus, Cochrane Library and Web of Science. Twelve studies were included in the meta‐analysis. The quality assessment and ROB were executed using NOS and ROB 2 respectively. RevMan software 5.4 was used for performing the analysis. Results The pooled analysis showed no significant difference between the administration of aspirin and the control group in decreased incidence of PE, hypertensive disorders, IUGR or twin‐to‐twin discordance (RR = 0.73, CI = 0.43–1.24, p = 0.24), (RR = 0.60, CI = 0.34–1.07, p = 0.08), (RR = 0.90, CI = 0.45–1.82, p = 0.77) and (RR = 1.76, CI = 0.83–3.73, p = 0.14), respectively. However, the pooled analysis showed a statistically significant association between aspirin and decreased incidence of preterm birth (PTB) (RR = 0.58, CI = 0.39–0.86, p = 0.006). Subgroup analysis of the dose revealed a significant association between 100 mg of aspirin and decreased PE incidence compared with the control group (RR = 0.44, CI = 0.23–0.84, p = 0.01). Conclusion The overall analysis showed no significant role of Aspirin in reducing the incidence of PE. The dose subgroup analysis revealed that only 100 mg of Aspirin is effective in decreasing PE. Future multicentre randomized control trials are warranted to give us conclusive results.

Keywords

• aspirin
• LDA
• preeclampsia
• preterm birth
• twin pregnancy