Figure 1035

Prevention of preeclampsia with low-dose aspirin. Investigators have sought methods to prevent preeclampsia (eg, salt restriction, prophylactic diuretics, and high-protein diets). One approach that has been extensively investigated in the last 10 years is therapy with low-dose aspirin. It was hypothesized that such therapy reversed the imbalance between prostacyclin and throm-boxane that may be responsible for some of the manifestations of the disease. Several large trials now have been completed, and most have had negative results. Shown here is an overview of the effects of aspirin on proteinuric preeclampsia reported from all trials of antiplatelet therapy (through 1994) as analyzed by the Collaborative Low-dose Aspirin in Pregnancy (CLASP) Collaborative Group [28]. Odds ratios (area proportional to amount of information contributed) and 99% confidence interval (CI) are plotted for various trials. A black square to the left of the solid vertical line suggests a benefit (however, this indication is significant at 2p >0.01 only if the entire CI is to the left of solid vertical line). (From CLASP Collaborative Group [29]; with permission.)

Study Marya et al.,1987 Villar et al.,1987 Lopez-Jaramillo et al.,1989 Lopez-Jaramillo et al.,1990 Montanaro et al.,1990 Villar and Repke,1990 Belizan et al.,1991 Cong et ai.,1993 Sanchez-Ramos et al.,1994 Pooled estimate

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