Efecto de la Aspirina en la Prevención de la Preeclampsia. Revisión Bibliográfica
Resumen
La preeclampsia es un trastorno hipertensivo que surge durante la gestación caracterizado por elevación en la presión arterial y complicaciones como proteinuria, disfunción orgánica y úteroplacentaria. La aspirina, antiinflamatorio no esteroideo, es usada en la prevención de la preeclampsia. Esta revisión se desarrolla con el objetivo de establecer el efecto de la aspirina como medida preventiva en la preeclampsia en embarazadas a través de una revisión sistémica. El estudio es de caracter descriptivo-explicativo y se apoya en artículos provenientes de bases de datos científicas, que incluyen PubMed, Scielo, Cochrane y Google Académico, empleando términos clave como "aspirina", "preeclampsia" y "prevención". Los hallazgos sugieren que la administración de aspirina, particularmente en dosis bajas (81 mg/día), reduce significativamente la incidencia de preeclampsia y complicaciones asociadas, como parto prematuro y mortalidad perinatal. No obstante, persisten interrogantes sobre la dosis óptima y el momento ideal para su administración. La aspirina presenta un perfil de seguridad favorable y es una estrategia preventiva efectiva, aunque se requiere más estudios que permitan precisar las condiciones de su uso.
Descargas
Citas
Ahn, T. G., & Hwang, J. Y. (2023). Preeclampsia and aspirin. Obstetrics & Gynecology Science, 66(3), 120–132. https://doi.org/10.5468/OGS.22261
Ayyash, M., Goyert, G., Garcia, R., Khangura, R., Pitts, D., Jacobsen, G., & Shaman, M. (2024). Efficacy and Safety of Aspirin 162 mg for Preeclampsia Prophylaxis in High-Risk Patients. American Journal of Perinatology, 41, E2410–E2417. https://doi.org/10.1055/S-0043-1771260
Blanco, E., Marin, M., Nuñez, L., Retamal, E., Ossa, X., Woolley, K. E., Oludotun, T., Bartington, S. E., Delgado-Saborit, J. M., Harrison, R. M., Ruiz-Rudolph, P., & Quinteros, M. E. (2022). Adverse pregnancy and perinatal outcomes in Latin America and the Caribbean: systematic review and meta-analysis. Revista Panamericana de Salud Publica, 46. https://doi.org/10.26633/RPSP.2022.21
Brownfoot, F., & Rolnik, D. L. (2024). Prevention of preeclampsia. Best Practice & Research. Clinical Obstetrics & Gynaecology, 93. https://doi.org/10.1016/J.BPOBGYN.2024.102481
Chang, K. J., Seow, K. M., & Chen, K. H. (2023). Preeclampsia: Recent Advances in Predicting, Preventing, and Managing the Maternal and Fetal Life-Threatening Condition. International Journal of Environmental Research and Public Health, 20(4), 2994. https://doi.org/10.3390/IJERPH20042994
Espeche, W. G., Minetto, J., & Salazar, M. R. (2022). Utilización de aspirina 100 mg/día para prevenir Preeclampsia, en embarazos de alto riego, en una cohorte de Argentina. Revista de La Facultad de Ciencias Médicas de Córdoba, 79(1), 4–9. https://doi.org/10.31053/1853.0605.V79.N1.32783
Ghesquiere, L., Guerby, P., Marchant, I., Kumar, N., Zare, M., Foisy, M. A., Roberge, S., & Bujold, E. (2023). Comparing aspirin 75 to 81 mg vs 150 to 162 mg for prevention of preterm preeclampsia: systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM, 5(7), 101000. https://doi.org/10.1016/J.AJOGMF.2023.101000
Gracia, P. V.-D. (2022). Evidencias del Ácido Acetilsalicílico (Aspirina) en la prevención de la preeclampsia: revisión narrativa. Revista Peruana de Ginecología y Obstetricia, 68(4). https://doi.org/10.31403/RPGO.V68I2453
Gregorio Barrientos, I. G. (2023). Ácido acetilsalicílico como método preventivo en embarazadas con riesgo de preeclampsia. Revista Diversidad Científica, 3(1), 177–185. https://doi.org/10.36314/DIVERSIDAD.V3I1.58
Hastie, R., Tong, S., Wikström, A. K., Sandström, A., Hesselman, S., & Bergman, L. (2021). Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study. American Journal of Obstetrics and Gynecology, 224(1), 95.e1-95.e12. https://doi.org/10.1016/J.AJOG.2020.07.023
Henderson, J. T., Vesco, K. K., Senger, C. A., Thomas, R. G., & Redmond, N. (2021). Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. In JAMA (Vol. 326, Issue 12, pp. 1192–1206). American Medical Association. https://doi.org/10.1001/jama.2021.8551
Jiang, Y., Chen, Z., Chen, Y., Wei, L., Gao, P., Zhang, J., Zhou, X., Zhu, S., Zhang, H., Du, Y., Fang, C., Su, R., Wang, S., Yu, J., He, M., Ding, W., & Feng, L. (2023). Low-dose asprin use during pregnancy may be a potential risk for postpartum hemorrhage and increased blood loss: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM, 5(4). https://doi.org/10.1016/J.AJOGMF.2023.100878
Kupka, E., Roberts, J. M., Mahdy, Z. A., Escudero, C., Bergman, L., & De Oliveira, L. (2024). Aspirin for preeclampsia prevention in low- and middle-income countries: mind the gaps. AJOG Global Reports, 4(2), 100352. https://doi.org/10.1016/J.XAGR.2024.100352
Lailler, G., Grave, C., Gabet, A., Regnault, N., Deneux-Tharaux, C., Kretz, S., Tsatsaris, V., Plu-Bureau, G., Blacher, J., & Olie, V. (2023). Aspirin for the Prevention of Early and Severe Pre-Eclampsia Recurrence: A Real-World Population-Based Study. Drugs, 83(5), 429. https://doi.org/10.1007/S40265-023-01842-3
Ma’ayeh, M., & Costantine, M. M. (2020). Prevention of preeclampsia. Seminars in Fetal & Neonatal Medicine, 25(5). https://doi.org/10.1016/J.SINY.2020.101123
Ma’ayeh, M., Rood, K. M., Kniss, D., & Costantine, M. M. (2020). Novel Interventions for the Prevention of Preeclampsia. Current Hypertension Reports, 22(2), 17. https://doi.org/10.1007/S11906-020-1026-8
Mkhize, P. Z., Dorsamy, V., Khaliq, O. P., Bagwandeen, C., & Moodley, J. (2024). The effectiveness of low-dose aspirin for the prevention of hypertensive disorders of pregnancy in a sub-Saharan Africa Country: A randomized clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 303, 259–265. https://doi.org/10.1016/J.EJOGRB.2024.10.052
MSP. (2016). Trastornos hipertensivos del embarazo. Guía de Práctica Clínica (GPC). http://salud.gob.ec
MSP. (2023). Gaceta epidemiológica de muerte maternas SE1 a SE52. https://www.salud.gob.ec/wp-content/uploads/2024/01/Gaceta-MM-SE-52-2023.pdf
Obstetricia y Ginecología. (2020). Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. https://doi.org/10.1097/AOG.0000000000003891
Patrono, C. (2023). Fifty years with aspirin and platelets. British Journal of Pharmacology, 180(1), 25–43. https://doi.org/10.1111/BPH.15966
Poon, L. C., Shennan, A., Hyett, J. A., Kapur, A., Hadar, E., Divakar, H., McAuliffe, F., da Silva Costa, F., von Dadelszen, P., McIntyre, H. D., Kihara, A. B., Di Renzo, G. C., Romero, R., D’Alton, M., Berghella, V., Nicolaides, K. H., & Hod, M. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. International Journal of Gynecology & Obstetrics, 145(S1), 1–33. https://doi.org/10.1002/IJGO.12802
Ren, Y., Zhao, Y., Yang, X., Shen, C., & Luo, H. (2023). Application of low dose aspirin in pre-eclampsia. Frontiers in Medicine, 10. https://doi.org/10.3389/FMED.2023.1111371
Roberts, J. M., King, T. L., Barton, J. R., Beck, S., Bernstein, I. M., Buck, T. E., Forgues-Lackie, M. A., Facco, F. L., Gernand, A. D., Graves, C. R., Jeyabalan, A., Hauspurg, A., Manuck, T. A., Myers, J. E., Powell, T. M., Sutton, E. F., Tinker, E., Tsigas, E., & Myatt, L. (2023). Care plan for individuals at risk for preeclampsia: shared approach to education, strategies for prevention, surveillance, and follow-up. American Journal of Obstetrics and Gynecology, 229(3), 193–213. https://doi.org/10.1016/j.ajog.2023.04.023
Rolnik, D. L., Nicolaides, K. H., & Poon, L. C. (2022). Prevention of preeclampsia with aspirin. American Journal of Obstetrics and Gynecology, 226(2S), S1108–S1119. https://doi.org/10.1016/J.AJOG.2020.08.045
Singh, N., Shuman, S., Chiofalo, J., Cabrera, M., & Smith, A. (2023). Missed opportunities in aspirin prescribing for preeclampsia prevention. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/S12884-023-06039-W
Souter, V., Painter, I., Sitcov, K., & Khalil, A. (2024). Propensity score analysis of low-dose aspirin and bleeding complications in pregnancy. Ultrasound in Obstetrics & Gynecology, 63(1), 81–87. https://doi.org/10.1002/UOG.27472
Van Doorn, R., Mukhtarova, N., Flyke, I. P., Lasarev, M., Kim, K. M., Hennekens, C. H., & Hoppe, K. K. (2021). Dose of aspirin to prevent preterm preeclampsia in women with moderate or high-risk factors: A systematic review and meta-analysis. PLOS ONE, 16(3), e0247782. https://doi.org/10.1371/JOURNAL.PONE.0247782
Werz, O., Stettler, H., Theurer, C., & Seibel, J. (2024). The 125th Anniversary of Aspirin—The Story Continues. Pharmaceuticals, 17(4), 437. https://doi.org/10.3390/PH17040437
Zhang, F., & Wang, H. (2024). Effect of low-dose aspirin intervention on pre-eclampsia prevention in high-risk pregnant women and its impact on postpartum hemorrhage. Frontiers in Medicine, 11. https://doi.org/10.3389/FMED.2024.1414697
Derechos de autor 2025 Karelys Alfonsina Cuenca Romero, Mileny Lisseth Hidalgo Erique , Maritza Brigida Agudo Gonzabay
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
.png)
.png)
1.png)
