Preventing Preeclampsia With Low-Dose Aspirin: A Systematic Review of Efficacy Across Diverse Populations

Rebecca George1, Zaheeruddin Sayed2, Hamesh Gundala Raja3

  • 1Obstetrics and Gynecology, Malankara Orthodox Syrian Church Medical College, Kolenchery, IND.

Cureus
|June 16, 2025
PubMed

This systematic review evaluates the efficacy of low-dose aspirin (LDA) in preventing preeclampsia in high-risk pregnancies. A comprehensive search of recent randomized controlled trials was conducted, focusing on studies published within the last five years. The review included five studies that investigated LDA at doses ranging from 60 mg to 150 mg, with outcomes measured in diverse populations. Findings indicate that LDA can reduce preeclampsia risk, particularly in specific subgroups such as non-Hispanic white women, but its efficacy is influenced by factors such as aspirin resistance, ethnicity, and biomarker levels. The review also highlights the importance of anti-inflammatory biomarkers like 15-epi-lipoxin A4 and IL-2 in understanding aspirin's mechanism of action. However, significant variability was observed across studies, suggesting that a personalized approach to aspirin prophylaxis may be necessary. This review underscores the need for future research to address gaps in aspirin efficacy across different populations and to explore biomarker-driven strategies for preeclampsia prevention.

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