Prevention of Pre-eclampsia: Low-dose Aspirin,Calcium and Antioxidants

Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality. Early deliver remains the only effective treatment for this condition. The purpose of this article is to review the role of low-dose aspirin and calcium supplements and to address the potential role of antioxidants in the prevention of pre-eclampsia.Early studies and meta-analysis suggested that low-dose aspirin reduced the incidence of pre-eclampsia. In more recent reports, large clinical trials studying health nulliparous women and women at higher risk for pre-eclampsia have shown that low-dose aspirin has little effect. Calcium supplements also ail to reduce the risk of developing pre-eclampsia in nulliparous women. Recent findings support the hypothesis that “oxidative stress” may be involved in the pathogenesis of pre-eclampsia. This has led to the suggestion that antioxidant therapy may be beneficial. The disappointing results of the large trials of aspirin and calcium suggest that better support for the role of oxidative stress should be available before such trials are undertaken.In summary, large clinical trials have not supported the encouraging results of smaller trials and meta-analysis. There is little evidence that low-dose aspirin or calcium is effective or the prevention of pre-eclampsia. Further advances in preventative therapy await a more thorough understanding of the pathophysiology of the disease process.