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Aspirin for the prevention of pre-eclampsia in women with pre-existing diabetes: Systematic review

Zen, Monica; Haider, Rabbia; Simmons, David; Peek, Michael; Nolan, Christopher; Padmanabhan, Suja; Jesudason, Shilpa; Alahakoon, Thushari I; Cheung, N Wah; Lee, Vincent W

Description

Background: There is a lack of evidence for pre-eclampsia prophylaxis with aspirin in women with pre-existing diabetes mellitus (DM). Aims: To examine the evidence for aspirin in pre-eclampsia prophylaxis in women with pre-existing DM. Material and Methods: An electronic search using Ovid MEDLINE, Embase, CinicalTrials.gov and the Cochrane CENTRAL register of controlled trials through to February 2021 was performed. Reference lists of identified studies, previous review articles, clinical...[Show more]

dc.contributor.authorZen, Monica
dc.contributor.authorHaider, Rabbia
dc.contributor.authorSimmons, David
dc.contributor.authorPeek, Michael
dc.contributor.authorNolan, Christopher
dc.contributor.authorPadmanabhan, Suja
dc.contributor.authorJesudason, Shilpa
dc.contributor.authorAlahakoon, Thushari I
dc.contributor.authorCheung, N Wah
dc.contributor.authorLee, Vincent W
dc.date.accessioned2023-08-25T01:23:28Z
dc.identifier.issn0004-8666
dc.identifier.urihttp://hdl.handle.net/1885/296848
dc.description.abstractBackground: There is a lack of evidence for pre-eclampsia prophylaxis with aspirin in women with pre-existing diabetes mellitus (DM). Aims: To examine the evidence for aspirin in pre-eclampsia prophylaxis in women with pre-existing DM. Material and Methods: An electronic search using Ovid MEDLINE, Embase, CinicalTrials.gov and the Cochrane CENTRAL register of controlled trials through to February 2021 was performed. Reference lists of identified studies, previous review articles, clinical practice guidelines and government reports were manually searched. Randomised controlled trials (RCTs) of aspirin vs placebo for pre-eclampsia prophylaxis were included. Articles were manually reviewed to determine if cohorts included women with DM. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data from included trials were extracted independently by two authors who also independently assessed risk of bias as per the Cochrane Handbook criteria version 5.1.0. Data were analysed using Rev-Man 5.4. Results: Forty RCTs were identified, of which 11 included a confirmed subset of women with DM; however, data were insufficient for meta-analysis. Meta-analysis of 930 women with DM, from individual patient data included in a systematic review and unpublished data from one of the 11 RCTs, showed a non-significant difference in the outcome of pre-eclampsia in participants treated with aspirin compared to placebo (odds ratio 0.58; 95% CI 0.20–1.71; P = 0.33). Conclusions: Pre-eclampsia risk reduction with aspirin prophylaxis in women with pre-existing DM may be similar to women without pre-existing DM. However, randomised data within this meta-analysis were insufficient, warranting the need for further studies within this high-risk group of women.
dc.description.sponsorshipMZ was supported by the National Health and Medical Research Council Postgraduate Scholarship. The funding body had no role in the design and conduct of the study
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBlackwell Publishing Ltd
dc.rights© 2021 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
dc.sourceAustralian and New Zealand Journal of Obstetrics and Gynecology
dc.subjectdiabetes mellitus
dc.subjectpre-eclampsia
dc.subjectaspirin
dc.subjectprevention
dc.titleAspirin for the prevention of pre-eclampsia in women with pre-existing diabetes: Systematic review
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume62
dc.date.issued2021
local.identifier.absfor321502 - Obstetrics and gynaecology
local.identifier.absfor320208 - Endocrinology
local.identifier.ariespublicationa383154xPUB23935
local.publisher.urlhttps://www.wiley.com/en-gb
local.type.statusPublished Version
local.contributor.affiliationZen, Monica, Westmead Hospital
local.contributor.affiliationHaider, Rabbia, Nepean Hospital
local.contributor.affiliationSimmons, David, Western Sydney University
local.contributor.affiliationPeek, M, College of Arts and Social Sciences, ANU
local.contributor.affiliationNolan, Christopher, College of Health and Medicine, ANU
local.contributor.affiliationPadmanabhan, Suja, Westmead Hospital, Sydney
local.contributor.affiliationJesudason, Shilpa, University of Adelaide
local.contributor.affiliationAlahakoon, Thushari I, Westmead Hospital
local.contributor.affiliationCheung, N Wah, Westmead Hospital
local.contributor.affiliationLee, Vincent W, The University of Sydney
local.description.embargo2099-12-31
local.bibliographicCitation.issue1(2022)
local.bibliographicCitation.startpage12
local.bibliographicCitation.lastpage21
local.identifier.doi10.1111/ajo.13460
local.identifier.absseo200509 - Women's and maternal health
dc.date.updated2022-07-24T08:20:00Z
local.identifier.scopusID2-s2.0-85119621295
CollectionsANU Research Publications

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