"REVIEWING THE EVIDENCE: ASPIRIN IN THE PREVENTION OF PRE-ECLAMPSIA"

Dr. Azher Sharif*, Leena Mohammed and Almira Aiman

ABSTRACT

Background: Pre-eclampsia is a complex, multisystem disorder affecting pregnant women, often leading to serious maternal and neonatal complications. Aspirin, known for its antiplatelet and anti-inflammatory properties, has been shown a positive effect for the pre- eclampsia in high-risk pregnancies. Objective: This review aims to explore the pharmacological mechanism of aspirin in the prevention of pre-eclampsia and evaluate current evidence from clinical trials, systematic reviews, and case reports. Methods: A literature review was conducted, including randomized controlled trials, meta- analyses, and case studies that investigated the efficacy and safety of low-dose aspirin in reducing the incidence and severity of pre-eclampsia. Emphasis was placed on dosage, timing of initiation, and maternal risk factors. Results: Current evidence indicates that aspirin, particularly in doses of 100–150 mg daily initiated before 16 weeks of gestation, can significantly reduce the risk of preterm pre- eclampsia and improve neonatal outcomes. Meta-analyses suggest that early prophylaxis lowers the risk of adverse outcomes, including foetal growth restriction and perinatal death, without increasing bleeding complications. However, variability in trial design and aspirin regimens contributes to inconsistencies in findings. Conclusion: Low-dose aspirin is a promising strategy for pre-eclampsia prevention in high- risk women. Early initiation and appropriate dosing are critical for optimal benefit. Further studies are warranted to refine patient selection criteria and establish universal guidelines.

Keywords: Aspirin, Acetylsalicylic acid, Pre-eclampsia, Low-dose, Pregnancy, Antiplatelet, Prophylaxis, Cyclooxygenase, Neonatal outcomes.