Abstract: Objective To estimate the effect of early intervention with aspirin for prevention of preeclampsia in high-risk
women. Methods A systematic review and meta-analysis were performed based on the principles and methods of Cochrane
systematic reviews. Electronic databases were searched for randomized trials comparing aspirin with either placebo or no
aspirin. Studies were included when meeting the inclusion criteria that the participants were pregnant women at a high risk of
preeclampsia and started aspirin therapy at 16 gestational weeks or earlier, which were assessed by two independent
reviewers. Meta-analysis was conducted using Review Manger 5.3 software. Results A total of 5 studies involving 860
participants were included in the final analysis. In the high-risk women, early use of aspirin showed an OR of 0.35 (95%CI
0.17-0.75) for preventing pregnancy-induced hypertension (PIH), 0.75 (95% CI 0.47-0.98) for preeclampsia, 0.53 (95% CI
0.29-0.98) for intrauterine growth retardation, and 0.20 (95% CI 0.08-0.48) for preterm birth; the average birth weight in aspirin
intervention group was 107.15 g (95%CI 76.13-138.18, P<0.001) more than that in the control group. Conclusion In high-risk
pregnancies, early aspirin intervention starting before 16 weeks of gestation can prevent PIH, preeclampsia, IUGR, and
preterm birth and help to increase the birth weight.