Optimal aspirin dosing for preeclampsia prevention

Abstract

Aspirin prophylaxis is recommended for women at higher risk of preeclampsia; yet, there is no consensus about the optimal dose., Moreover, in North America, aspirin is routinely only available in 81 mg and 325 mg tablets. While a recent metaanalysis suggested a dose-response effect, limitations therein included the inability to control for trial effects and maternal risk factors and a susceptibility to publication bias. Metaanalyses that use aggregate data pooled from different randomized controlled trials (RCTs) are also more likely to overestimate aspirin’s efficacy compared with those metaanalyses that use individual participant data (IPD). In response, we evaluated the efficacy of aspirin at different doses, using IPD from a large metaanalysis of preeclampsia prevention1 and then compared those findings to that of the recent Aspirin for Evidence-based Preeclampsia Prevention trial (ASPRE).