Abstract

Background: Preterm birth is a key contributor of neonatal morbidity and mortality and a considerable threat is posed to maternaland child health. To counter the threat, many different interventions have been used including aspirin intervention during earlypregnancy. Aspirin, because of its anti-inflammatory and anti-platelet properties has been found to be efficient in reducing pretermbirth rate if given during early pregnancy. In this systematic review we intend to appraise the role of aspirin in low dose in reducingthe 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 duringearly pregnancy.Methods: A comprehensive literature search from 3 databases (PubMed, Google Scholar and PakMediNet) was conducted yielding16 final articles. Our inclusion criteria was limited to studies published from January 2013 to January 2023 and about the use ofaspirin in prevent preterm birth in early pregnancy. To ensure transparency in the systematic review, we strictly followed PRISMAguidelines. 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 Randomizedcontrolled trials studies. We studied effect of aspirin in preventing preterm birth while administered during early pregnancy basedon 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 inpreterm 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 inpost-partum hemorrhage was shown in 4 studies while one study showed its increase. One study showed increase while 2 showedno effect on birth weight. 3 studies showed that there was no effect of aspirin on gestational age. One study showed reduction inhospital 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 earlypregnancy. As evident from majority of included studies, there is a decreasing trend in preterm births with aspirin used during earlypregnancy. Researchers and obstetric healthcare workers can recognize and utilize this promising role of aspirin in preventingspontaneous preterm births during early pregnancy.