Low-dose aspirin for prevention of adverse outcomes related to abnormal placentation


  • Funding sources: Emmanuel Bujold researches are supported by the Jeanne and Jean-Louis Lévesque Perinatal Research Chair at Université Laval, Quebec, QC, Canada

  • Conflicts of interest: Emmanuel Bujold holds a Clinician Scientist Award from the Canadian Institutes of Health Research (CIHR). Stéphanie Roberge holds a PhD Award from the Fonds de la Recherche du Québec - Santé (FRQS)


Meta-analysis of randomized studies on the use of low-dose aspirin in women at high risk of preeclampsia (PE) has demonstrated that if treatment is initiated at ≤16 weeks' gestation, there is significant reduction in the risk of PE [relative risk (RR) 0.47, 95% confidence interval (CI) 0.36–0.62], fetal growth restriction (RR 0.46, 95% CI 0.33–0.64), preterm birth (RR 0.35, 95% CI 0.22–0.57) and perinatal death (RR 0.41, 95% CI 0.19–0.92), whereas the effect of treatment after 16 weeks is substantially less (RR 0.78, 95% CI 0.61–0.99; RR 0.98, 95% CI 0.88–1.08; RR 0.90, 95% CI 0.83–0.97; and RR 0.93, 95% CI 0.73–1.19, respectively). Moreover, the decrease in the risk of PE from early onset treatment seems to be related to the dose of aspirin, and a dose of >80 mg daily should be considered for optimal benefits. © 2014 John Wiley & Sons, Ltd.