PMID- 38372754
OWN - NLM
STAT- MEDLINE
DCOM- 20240416
LR  - 20240416
IS  - 1432-0711 (Electronic)
IS  - 0932-0067 (Linking)
VI  - 309
IP  - 5
DP  - 2024 May
TI  - The effects of low-dose aspirin on preterm birth: a systematic review and 
      meta-analysis of randomized controlled trials.
PG  - 1775-1786
LID - 10.1007/s00404-024-07373-w [doi]
AB  - AIM: To conduct a systematic review and meta-analysis of all randomized 
      controlled trials (RCTs) that evaluated the efficacy of low-dose aspirin 
      (LDA, </= 160 mg/day) on preventing preterm birth (PB). METHODS: Five databases 
      were screened from inception until June 25, 2023. The RCTs were assessed for 
      quality according to Cochrane's risk of bias tool. The endpoints were summarized 
      as risk ratio (RR) with 95% confidence interval (CI). RESULTS: Overall, 40 RCTs 
      were analyzed. LDA significantly decreased the risk of PB < 37 weeks (RR: 0.91, 
      95% CI 0.87, 0.96, p < 0.001, moderate certainty of evidence) with low 
      between-study heterogeneity (I(2) = 23.2%, p = 0.11), and PB < 34 weeks (RR: 
      0.78, 95% CI 0.61, 0.99, p = 0.04, low certainty of evidence) with high 
      between-study heterogeneity (I(2) = 58.3%, p = 0.01). There were no significant 
      differences between both groups regarding the risk of spontaneous (RR: 0.94, 95% 
      CI 0.83, 1.07, p = 0.37) and medically indicated (RR: 1.28, 95% CI 0.87, 1.88, 
      p = 0.21) BP < 37 weeks. Sensitivity analysis revealed robustness for all 
      outcomes, except for the risk of PB < 34 weeks. For PB < 37 weeks and 
      PB < 34 weeks, publication bias was detected based on visual inspection of funnel 
      plots for asymmetry and statistical significance for Egger's test (p = 0.009 and 
      p = 0.0012, respectively). CONCLUSION: LDA can significantly reduce the risk of 
      PB < 37 and < 34 weeks. Nevertheless, further high-quality RCTs conducted in 
      diverse populations, while accounting for potential confounding factors, are 
      imperative to elucidate the optimal aspirin dosage, timing of initiation, and 
      treatment duration for preventing preterm birth and to arrive at definitive 
      conclusions.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Baradwan, Saeed
AU  - Baradwan S
AD  - Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and 
      Research Center, Jeddah, Saudi Arabia.
FAU - Tawfiq, Afaf
AU  - Tawfiq A
AD  - Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and 
      Research Center, Jeddah, Saudi Arabia.
FAU - Hakeem, Ghaidaa Farouk
AU  - Hakeem GF
AD  - Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and 
      Research Center, Jeddah, Saudi Arabia.
FAU - Alkaff, Alya
AU  - Alkaff A
AD  - Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and 
      Research Center, Jeddah, Saudi Arabia.
FAU - Hafedh, Bandr
AU  - Hafedh B
AD  - Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and 
      Research Center, Jeddah, Saudi Arabia.
FAU - Faden, Yaser
AU  - Faden Y
AD  - College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Khadawardi, Khalid
AU  - Khadawardi K
AD  - Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura 
      University, Makkah, Saudi Arabia.
FAU - Abdulghani, Sahar H
AU  - Abdulghani SH
AD  - Department of Obstetrics and Gynecology, Security Forces Hospital Program, 
      Riyadh, Saudi Arabia.
FAU - Althagafi, Hanin
AU  - Althagafi H
AD  - Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King 
      Abdulaziz University, Jeddah, Saudi Arabia.
FAU - Abu-Zaid, Ahmed
AU  - Abu-Zaid A
AUID- ORCID: 0000-0003-2286-2181
AD  - Department of Obstetrics and Gynecology, College of Medicine, Alfaisal 
      University, Riyadh, Saudi Arabia. aabuzaid@live.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20240219
PL  - Germany
TA  - Arch Gynecol Obstet
JT  - Archives of gynecology and obstetrics
JID - 8710213
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Infant, Newborn
MH  - Female
MH  - Humans
MH  - *Premature Birth/prevention & control/drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Aspirin/therapeutic use
OTO - NOTNLM
OT  - Aspirin
OT  - Meta-analysis
OT  - Pregnancy
OT  - Preterm birth
EDAT- 2024/02/19 12:42
MHDA- 2024/04/16 12:42
CRDT- 2024/02/19 11:04
PHST- 2023/11/08 00:00 [received]
PHST- 2024/01/02 00:00 [accepted]
PHST- 2024/04/16 12:42 [medline]
PHST- 2024/02/19 12:42 [pubmed]
PHST- 2024/02/19 11:04 [entrez]
AID - 10.1007/s00404-024-07373-w [pii]
AID - 10.1007/s00404-024-07373-w [doi]
PST - ppublish
SO  - Arch Gynecol Obstet. 2024 May;309(5):1775-1786. doi: 10.1007/s00404-024-07373-w. 
      Epub 2024 Feb 19.