An Overview of Prophylactic Acetylsalicylic Acid for the Prevention of Intra-uterine Growth Restriction (IUGR) in Women at Risk for Preeclampsia

Background: Preeclampsia is a major global cause of maternal, neonatal and perinatal mortality. The aim of this review was to summarize all reviews on Acetylsalicylic Acid for the prevention of Intra-uterine Growth Restriction (IUGR) in women at risk for Preeclampsia. Materials and Methods: In this overview we searched databases following Medline, Scopus, EMBASE, Central Records Central Register Cochrane and the Web of Science databases for finding related articles regarding Acetylsalicylic Acid on the prevention of IUGR in women at high risk for Preeclampsia. Search was conducted from 1996 to 5 April 2019 with English keywords. Any meta-analysis (published or unpublished), was eligible for inclusion. No language restriction was imposed. Results: Finally eight meta-analysis were included in the review. Acetylsalicylic acid begun at 16≤weeks significantly reduced IUGR in women; but it was not effective in the subgroups of women who took acetylsalicylic acid when they had gestational age of more than 16 weeks. One meta-analysis showed that acetylsalicylic acid was superior to control group in decreasing of IUGR in East Asians (OR=0.36); while no significant effectiveness was observed in non-East Asians (OR = 0.85).  According to one meta-analysis, a dose-response effect of acetylsalicylic acid (p=0.04) on IUGR was observed if it was begun at 16≤ weeks. However, a dose-response effect (p= 0.95) was not seen if women started acetylsalicylic acid when they were in gestational age more than 16 weeks. Conclusion: Acetylsalicylic acid has decreased the incidence of IUGR if administrated before or at 16 weeks. Acetylsalicylic acid was superior to control group in decreasing IUGR risk in East Asians but not in non-East Asians.