Abstract
Background: Preterm birth is a key contributor of neonatal morbidity and mortality and a considerable threat is posed to maternal
and child health. To counter the threat, many different interventions have been used including aspirin intervention during early
pregnancy. Aspirin, because of its anti-inflammatory and anti-platelet properties has been found to be efficient in reducing preterm
birth rate if given during early pregnancy. In this systematic review we intend to appraise the role of aspirin in low dose in reducing
the rate of premature delivery while administered during early pregnancy.
Objective: To determine whether the rate of spontaneous preterm births is reduced by administering aspirin in low dose during
early pregnancy.
Methods: A comprehensive literature search from 3 databases (PubMed, Google Scholar and PakMediNet) was conducted yielding
16 final articles. Our inclusion criteria was limited to studies published from January 2013 to January 2023 and about the use of
aspirin in prevent preterm birth in early pregnancy. To ensure transparency in the systematic review, we strictly followed PRISMA
guidelines. Finally, we extracted the results of aspirin interventions from these studies and assembled and analyzed the final results.
Results: Out of the 362 studies from initial studies, 16 articles were finalized for the systematic review, which included 10 Randomized
controlled trials studies. We studied effect of aspirin in preventing preterm birth while administered during early pregnancy based
on some primary outcomes i.e. reduction in preterm birth; and secondary outcomes i.e. pre-eclampsia, post-partum hemorrhage,
birth weight, gestational age and hospital length of stay. Of the 16 research articles, 13 (81%) showed a considerable decrease in
preterm birth rate while only 3 (19%) studies showed no remarkable decline in preterm birth rate. In analysis of secondary outcomes,
pre-eclampsia showed reduction in 8 studies while one study showed increase and one showed no effect on pre-eclampsia. Reduction in
post-partum hemorrhage was shown in 4 studies while one study showed its increase. One study showed increase while 2 showed
no effect on birth weight. 3 studies showed that there was no effect of aspirin on gestational age. One study showed reduction in
hospital length of stay of mother upon aspirin intervention during early pregnancy.
Conclusion: This systematic review emphasis the role of aspirin in preventing preterm birth while administered during early
pregnancy. As evident from majority of included studies, there is a decreasing trend in preterm births with aspirin used during early
pregnancy. Researchers and obstetric healthcare workers can recognize and utilize this promising role of aspirin in preventing
spontaneous preterm births during early pregnancy.