[Aspirin and preeclampsia]

Presse Med. 2019 Jan;48(1 Pt 1):34-45. doi: 10.1016/j.lpm.2018.11.022. Epub 2019 Jan 18.
[Article in French]

Abstract

Indications for aspirin during pregnancy are a matter of debate and there is a recent trend to an extended prescription and an overuse of aspirin in pregnancy. Aspirin is efficient in secondary prevention of preeclampsia essentially in patients with a personal history of preeclampsia. The effect of aspirin on platelet aggregation and on the TXA2/PGI2 balance is dose-dependent. The optimum dosage, from 75mg/day to 150mg/day, needs to be determined. Fetal safety data at 150mg/day are still limited. The efficacy of aspirin seems to be subject to a chronobiological effect. It is recommended to prescribe an evening or bedtime intake. Aspirin, in primary prevention of preeclampsia, given to high-risk patients identified in the first trimester by screening tests, seems to reduce the occurrence of early-onset preeclampsia. Nevertheless, there are insufficient data for the implementation of such screening procedures in practice.

Publication types

  • Review

MeSH terms

  • Aspirin / administration & dosage
  • Aspirin / adverse effects
  • Aspirin / pharmacokinetics
  • Aspirin / therapeutic use*
  • Chronobiology Phenomena
  • Contraindications, Drug
  • Cyclooxygenase Inhibitors / administration & dosage
  • Cyclooxygenase Inhibitors / adverse effects
  • Cyclooxygenase Inhibitors / pharmacokinetics
  • Cyclooxygenase Inhibitors / therapeutic use
  • Drug Utilization
  • Early Diagnosis
  • Female
  • Fetal Diseases / chemically induced
  • France / epidemiology
  • Humans
  • Mass Screening
  • Meta-Analysis as Topic
  • Placenta / metabolism
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / pharmacokinetics
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Pre-Eclampsia / diagnosis
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / prevention & control*
  • Pregnancy
  • Pregnancy Complications / chemically induced
  • Pregnancy Trimester, First
  • Primary Prevention
  • Prostaglandin Antagonists / administration & dosage
  • Prostaglandin Antagonists / adverse effects
  • Prostaglandin Antagonists / pharmacokinetics
  • Prostaglandin Antagonists / therapeutic use
  • Risk Factors
  • Secondary Prevention

Substances

  • Cyclooxygenase Inhibitors
  • Platelet Aggregation Inhibitors
  • Prostaglandin Antagonists
  • Aspirin