{"title":"Impact of low-dose aspirin on maternal haemoglobin levels during pregnancy: a protocol for a systematic review and meta-analysis.","authors":"Nokwethemba Monica Ngcobo, Vino Dorsamy, Chauntelle Bagwandeen","doi":"10.1186/s13643-026-03219-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aspirin, a cyclooxygenase (COX) inhibitor with anti-inflammatory and antiplatelet properties, is widely used during pregnancy to prevent preeclampsia (PE) and intrauterine growth restriction (IUGR). Despite its benefits, low-dose aspirin (LDA) has been linked to obstetric haemorrhage, including postpartum haemorrhage (PPH), and may influence haemoglobin (Hb) levels via its iron-chelating effects. The potential combined impact of LDA on Hb levels and pregnancy outcomes, however, remains unclear. This systematic review protocol aims to evaluate the effect of LDA on maternal Hb levels during pregnancy.</p><p><strong>Methods: </strong>Following PRISMA-P guidelines, comprehensive searches will be conducted in PubMed, Cochrane Library, Embase, Scopus, Web of Science, and ClinicalTrials.gov, as well as grey literature sources. Eligible studies will include randomised controlled trials (RCTs), cohort studies, and case-control studies reporting Hb levels in pregnant women using LDA. Two independent reviewers will perform screening, data extraction, and quality appraisal. Data will be synthesised using meta-analysis where feasible, with subgroup analyses to explore heterogeneity, and narrative synthesis for studies not suitable for pooling.</p><p><strong>Results: </strong>The systematic review will generate pooled evidence on how LDA affects maternal Hb levels and associated pregnancy outcomes such as PE and fetal growth.</p><p><strong>Conclusions: </strong>The findings may assist in refining clinical recommendations for LDA use in pregnancy by balancing its preventive benefits with potential risks related to anaemia, and haemorrhage.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024556220.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523184/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Systematic Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13643-026-03219-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Aspirin, a cyclooxygenase (COX) inhibitor with anti-inflammatory and antiplatelet properties, is widely used during pregnancy to prevent preeclampsia (PE) and intrauterine growth restriction (IUGR). Despite its benefits, low-dose aspirin (LDA) has been linked to obstetric haemorrhage, including postpartum haemorrhage (PPH), and may influence haemoglobin (Hb) levels via its iron-chelating effects. The potential combined impact of LDA on Hb levels and pregnancy outcomes, however, remains unclear. This systematic review protocol aims to evaluate the effect of LDA on maternal Hb levels during pregnancy.
Methods: Following PRISMA-P guidelines, comprehensive searches will be conducted in PubMed, Cochrane Library, Embase, Scopus, Web of Science, and ClinicalTrials.gov, as well as grey literature sources. Eligible studies will include randomised controlled trials (RCTs), cohort studies, and case-control studies reporting Hb levels in pregnant women using LDA. Two independent reviewers will perform screening, data extraction, and quality appraisal. Data will be synthesised using meta-analysis where feasible, with subgroup analyses to explore heterogeneity, and narrative synthesis for studies not suitable for pooling.
Results: The systematic review will generate pooled evidence on how LDA affects maternal Hb levels and associated pregnancy outcomes such as PE and fetal growth.
Conclusions: The findings may assist in refining clinical recommendations for LDA use in pregnancy by balancing its preventive benefits with potential risks related to anaemia, and haemorrhage.
背景：阿司匹林是一种环氧化酶（COX）抑制剂，具有抗炎和抗血小板的特性，在妊娠期间被广泛用于预防先兆子痫（PE）和宫内生长受限（IUGR）。尽管有益处，但低剂量阿司匹林（LDA）与产科出血（包括产后出血（PPH））有关，并可能通过其铁螯合作用影响血红蛋白（Hb）水平。然而，LDA对Hb水平和妊娠结局的潜在综合影响仍不清楚。本系统评价方案旨在评估LDA对妊娠期间产妇Hb水平的影响。方法：按照PRISMA-P指南，在PubMed、Cochrane Library、Embase、Scopus、Web of Science和ClinicalTrials.gov以及灰色文献来源中进行综合检索。符合条件的研究将包括随机对照试验（rct）、队列研究和病例对照研究，这些研究报告了使用LDA的孕妇的Hb水平。两名独立评审员将进行筛选、数据提取和质量评估。在可行的情况下，将使用荟萃分析来综合数据，并使用亚组分析来探索异质性，对不适合合并的研究进行叙事综合。结果：系统评价将产生关于LDA如何影响母亲Hb水平和相关妊娠结局（如PE和胎儿生长）的综合证据。结论：通过平衡LDA的预防益处和与贫血和出血相关的潜在风险，研究结果可能有助于完善妊娠期使用LDA的临床建议。系统评价注册号：PROSPERO CRD42024556220。
期刊介绍：
Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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