Prevention In Patients At High Risk Of Preeclampsia By Heparin In Addition To Low-dose Aspirin: A Meta-analysis

Objective: To evaluate the preventive effect on the combination of low molecular weight heparin and aspirin in high risk population of preeclampsia.Methods: All articles were retrieved from Pubmed,Medline,CNKI,Vip,Wangfang electronic databases,using key words like “aspirin”,“low molecular weight heparin”,“gestational hypertension”,“eclampsia”,“pre-eclampsia”,“chronic hypertension”.The Meta-analysis used revman5.2 software to calculate the relative risk(RR)and 95%confidence intervals,and enrolled Heterogeneity analysis,Sensitivity analysis and Publication bias.Results: 1.After the treatment of low molecular weight heparin combined with aspirin,the incidence of hypertension in pregnancy was significantly reduced compared with the control group [RR=0.59,95%CI(0.49-0.72),P<0.05].2.Low molecular weight heparin sodium or low molecular weight heparin calcium in combination with aspirin can significantly reduce the incidence of hypertensive disorders during pregnancy in high-risk groups with preeclampsia[RR=0.67,95%CI(0.51-0.87),P<0.05;RR=0.65,95%CI(0.45-0.94),P<0.05].3.The combination treatment of low molecular weight heparin with aspirin increased the live birth rate [RR=1.23,95%CI(1.13-1.34),P<0.05],also reduced the incidence of preterm delivery,placental abruption,and fetal growth restriction gastrointestinal tract reaction [RR=0.78,95%CI(0.65-0.94),P<0.05;RR=0.41,95%CI(0.24-0.72),P<0.05;RR=0.63,95%CI(0.51-0.78),P<0.05;RR=0.67,95%CI(0.47-0.95),P<0.05].4.Combined treatment with LMWH and aspirin did not increase the incidence of postpartum bleeding [RR=0.83,95%CI(0.55-1.24),P>0.05].Conclusion: The combination of LMWH and aspirin can effectively prevent the occurrence of preeclampsia without increasing the risk of other adverse pregnancy outcomes.