The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis
American Journal of Obstetrics and Gynecology, Volume 216, Issue 2, February 2017, Pages 95-97
https://doi.org/10.1016/j.ajog.2016.09.076
Presented as an oral presentation at the 14th World Congress in Fetal Medicine, Crete, Greece, June 23, 2015.
Pages listed in BOTH the categories Pregnancy and Hypertension (preeclampsia)
- Low Vitamin D is a top predictor of adverse events during pregnancy – Feb 2024
- Preeclampsia reduced by 33 percent if high vitamin D – meta-analysis Feb 2023
- Risk of preeclampsia should drop to nearly zero at 60 ng of Vitamin D – July 2022
- Hypertension during pregnancy: low Vitamin D, poor Vit. D genes – June 2022
- Low Vitamin D associated with preeclampsia - meta-analysis Feb 2022
- Low Vitamin D associated with pre-eclampsia -40th meta-analysis – Feb 2022
- Preeclampsia reduced by Vitamin D - many studies
- Preeclampsia (hypertension while pregnant) varies with season (O.R. 0.57) – June 2021
- Preeclampsia (low vitamin D) doubles the risk of later cardiovascular problems – Sept 2019
- Preeclampsia 11X more likely if poor Vitamin D Binding Protein (South Africa) - Sept 2019
- Preeclampsia 2X more likely if poor Vitamin D Receptor – April 2019
- Preeclampsia reduced 1.7 X by aspirin (but reduced 7 X by Vitamin D) – Feb 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Preeclampsia of offspring cut in half if mother who smoked had vitamin D fortified margarine – Dec 2017
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Child 49 percent higher risk of being overweight if preeclampsia during pregnancy – Sept 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Preeclampsia is not reduced by vitamin D (if you ignore vitamin D level, dose size, frequency and duration) – July 2017
- Preeclampsia doubles the risk of mild cognitive impairment – July 2017
- No Preeclampsia during pregnancy if more than 60 ng of vitamin D – RCT July 2013
- Preeclampsia changes to Vitamin D Binding Protein reduces Vitamin D in placenta – Dec 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Preeclampsia 4X less likely if vitamin D levels increased by 8 ng during pregnancy – March 2016
- Preeclampsia 2X more likely if low vitamin D, unless adjust for vitamin D factors (BMI, skin color) – Dec 2015
- Preeclampsia and eclampsia associated with lower vitamin D, etc. – Sept 2015
- Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Burka clothing reduces vitamin D levels, which causes pregnancy problems – Oct 2015
- Preeclampsia – hypothesis as to why vitamin D helps – June 2015
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
- Hypertension in pregnancy (preeclampsia) more frequent in winter (low vitamin D) – Jan 2015
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 40 percent less likely if mother had more than 20 ng of vitamin D – Jan 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 7X increase in early severe preeclampsia associated with low vitamin D – Aug 2012
- 200 IU of Vitamin D does not prevent preeclampsia – RCT Aug 2012
- Preeclampsia 3X more likely if low vitamin D at 25th week – April 2012
- Low vitamin D results in severe preeclampsia and low birth weight – Mar 2011
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- Seasonal variation on preeclampsia is correlated with sunlight intensity - June 2010
Vitamin D also provides many other benefits during pregnancy
Healthy pregnancies need lots of vitamin D has the following summary
Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
Click on hyperlinks for details
Problem | Vit. D Reduces | Evidence |
| 0. Chance of not conceiving | 3.4 times | Observe |
| 1. Miscarriage | 2.5 times | Observe |
| 2. Pre-eclampsia | 3.6 times | RCT |
| 3. Gestational Diabetes | 3 times | RCT |
| 4. Good 2nd trimester sleep quality | 3.5 times | Observe |
| 5. Premature birth | 2 times | RCT |
| 6. C-section - unplanned | 1.6 times | Observe |
| Stillbirth - OMEGA-3 | 4 times | RCT - Omega-3 |
| 7. Depression AFTER pregnancy | 1.4 times | RCT |
| 8. Small for Gestational Age | 1.6 times | meta-analysis |
| 9. Infant height, weight, head size within normal limits | RCT | |
| 10. Childhood Wheezing | 1.3 times | RCT |
| 11. Additional child is Autistic | 4 times | Intervention |
| 12.Young adult Multiple Sclerosis | 1.9 times | Observe |
| 13. Preeclampsia in young adult | 3.5 times | RCT |
| 14. Good motor skills @ age 3 | 1.4 times | Observe |
| 15. Childhood Mite allergy | 5 times | RCT |
| 16. Childhood Respiratory Tract visits | 2.5 times | RCT |
RCT = Randomized Controlled Trial
See also VitaminDWiki
- Off topic: Baby-sized aspirin doubles chance of getting wet macular degeneration
- Vitamin D Reduces Medical Problems better than aspirin
- What can Vitamin D learn from Baby Aspirin
See also web
- Low-Dose Aspirin for the Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force
- Risk Threshold for Starting Low Dose Aspirin in Pregnancy to Prevent Preeclampsia: An Opportunity at a Low Cost PLOS 2016 free PDF online
- Low-Dose Aspirin Use During Pregnancy ACOG
- Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies 2016
- Low-Dose Aspirin for Preventing Preeclampsia and Its Complications: A Meta-Analysis 2015 free PDF
Low-dose aspirin can reduce the incidence of- preeclampsia odds ratio,0.7
- severe preeclampsia 0.37
- preterm birth 0.81
Background
Preeclampsia and fetal growth restriction are major causes of perinatal death and handicap in survivors. Randomized clinical trials have reported that the risk of preeclampsia, severe preeclampsia, and fetal growth restriction can be reduced by the prophylactic use of aspirin in high-risk women, but the appropriate dose of the drug to achieve this objective is not certain.
Objective
We sought to estimate the impact of aspirin dosage on the prevention of preeclampsia, severe preeclampsia, and fetal growth restriction.
Study Design
We performed a systematic review and meta-analysis of randomized controlled trials comparing the effect of daily aspirin or placebo (or no treatment) during pregnancy. We searched MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials up to December 2015, and study bibliographies were reviewed. Authors were contacted to obtain additional data when needed. Relative risks for preeclampsia, severe preeclampsia, and fetal growth restriction were calculated with 95% confidence intervals using random-effect models. Dose-response effect was evaluated using meta-regression and reported as adjusted R2. Analyses were stratified according to gestational age at initiation of aspirin (≤16 and >16 weeks) and repeated after exclusion of studies at high risk of biases.
Results
In all, 45 randomized controlled trials included a total of 20,909 pregnant women randomized to between 50-150 mg of aspirin daily. When aspirin was initiated at ≤16 weeks, there was a significant reduction and a dose-response effect for the
- prevention of preeclampsia (relative risk, 0.57; 95% confidence interval, 0.43–0.75; P < .001; R2, 44%; P = .036),
- severe preeclampsia (relative risk, 0.47; 95% confidence interval, 0.26–0.83; P = .009; R2, 100%; P = .008), and
- fetal growth restriction (relative risk, 0.56; 95% confidence interval, 0.44–0.70; P < .001; R2, 100%; P = .044)
with higher dosages of aspirin being associated with greater reduction of the 3 outcomes. Similar results were observed after the exclusion of studies at high risk of biases. When aspirin was initiated at >16 weeks, there was a smaller reduction of preeclampsia (relative risk, 0.81; 95% confidence interval, 0.66–0.99; P = .04) without relationship with aspirin dosage (R2, 0%; P = .941). Aspirin initiated at >16 weeks was not associated with a risk reduction or a dose-response effect for severe preeclampsia (relative risk, 0.85; 95% confidence interval, 0.64–1.14; P = .28; R2, 0%; P = .838) and fetal growth restriction (relative risk, 0.95; 95% confidence interval, 0.86–1.05; P = .34; R2, not available; P = .563).
Conclusion
Prevention of preeclampsia and fetal growth restriction using aspirin in early pregnancy is associated with a dose-response effect. Low-dose aspirin initiated at >16 weeks’ gestation has a modest or no impact on the risk of preeclampsia, severe preeclampsia, and fetal growth restriction. Women at high risk for those outcomes should be identified in early pregnancy.