Efficacy and safety of low-dose aspirin combined with low-molecular-weight heparin in treatment of preeclampsia: a meta-analysis and systematic review

Abstract

IntroductionThe role of low-dose aspirin combined with low-molecu�lar-weight heparin (LMWH) in the treatment of preeclampsia (PE) remains unclear. We aimed to assess the efficacy and safety of low-dose aspirin combined with LMWH in PE treatment, to provide evidence for clinical PE management.Material and methodsWe searched PubMed and other databases for ran�domized controlled trials (RCTs) on the effects and safety of low-dose aspi�rin and LMWH in the treatment of PE up to January 31, 2021. Two research�ers strictly followed the inclusion and exclusion criteria to independently conduct the literature screening, data extraction and quality evaluation. We used RevMan 5.3 statistical software for synthesized analysis.ResultsA  total of 8 RCTs involving 861 patients were included. The syn�thesized outcome indicated that the differences in systolic blood pressure (MD = –10.61, 95% CI: –13.19 – –8.02), diastolic blood pressure (MD = –9.24, 95% CI: –14.49– –4.00), 24-hour urinary protein (MD = –2.24, 95% CI: –3.97– –0.50), prothrombin time (MD = 1.42, 95% CI: 0.53–2.32), ac�tivated partial thromboplastin time (MD = 2.91, 95% CI: 2.06–3.75), FIB (MD = –1.24, 95% CI: –1.32– –1.15), and adverse perinatal outcomes (MD = 0.41, 95% CI: 0.20–0.85) between the two groups were statistically significant (all p < 0.05), while the difference in the adverse reactions of pregnant women (MD = 0.44, 95% CI: 0.18–1.10) between the two groups was not statistically significant (p = 0.08). No publication bias was detected in all the synthesized outcomes (all p > 0.05).ConclusionsLow-dose aspirin combined with LMWH treatment of PE may be advantageous to improve blood pressure, 24-hour proteinuria and coagu�lation function, and it may reduce the adverse reactions in pregnant women without increasing adverse perinatal outcomes.