-Is prevention of pre-eclampsia with low dosage aspirin possible? Critical assessment of available studies-

The efficacy of low-dose aspirin treatment to prevent preeclampsia was assessed by reviewing studies of the available literature. 9 studies were performed examining nearly 13,000 pregnant women. Aspirin treatment compared with untreated control groups led to a significant reduction of preeclampsia in 5 small-scale studies. However, no prophylaxis could be achieved in 4 studies comprising more than 12,000 pregnant women. A assessment of low-dose aspirin treatment is difficult, since no dose-response study was performed to determine the optimal dose; the duration of treatment--beginning and end--was not defined and the drug risk for mother and child was not documented in accordance with GCP guidelines. The major problem of all studies, however, consisted in the recruitment of the patients since there are no easily performable and well-recognised screening tests available to estimate the risk of preeclampsia. In conclusion, at present no statement is possible if and under which conditions low-dose aspirin treatment will be able to prevent preeclampsia.