Meta AnalysisID 7687
低分子肝素联合阿司匹林预防胎儿生长受限：系统评价与Meta分析
CRD42023446340
This study is to estimate the efficacy and safety of low molecular weight heparin combined with aspirin on the incidence of fetal growth restriction (FGR), among gestating women at risk of FGR.
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Record Fields
Scalar fields from the final meta_analysis record.
- Meta Analysis Id
- 7687
- Evidence Id
- 16245
- Core Evidence Id
- 16245
- Source Meta Analysis Id
- 7681
- Herb2 Meta Analysis Id
- HBMA007681
- Crd Id
- CRD42023446340
- Title
- Low Molecular Weight Heparin Combined with Aspirin for the Prevention of Fetal Growth Restriction: a systematic review and meta-analysis
- Review Question
- This study is to estimate the efficacy and safety of low molecular weight heparin combined with aspirin on the incidence of fetal growth restriction (FGR), among gestating women at risk of FGR.
- Study Type Included
- We will consider for inclusion both clinical trials and observational cohort studies, either prospective or retrospective.
- Condition Being Studied
- Fetal growth restriction (FGR), also known as intrauterine growth restriction (IUGR), includes different conditions in which a fetus fails to reach the full growth. It has been found that fetuses with FGR are susceptible to intrauterine distress, neonatal asphyxia, meconium aspiration syndrome, preterm delivery, and intrauterine death during the perinatal period. Suboptimal fetal growth is important as SGA babies comprise 28-45% of non-anomalous stillbirths. The management of FGR is based on the prolongation of pregnancy long enough for fetal organs to mature while avoiding irreversible fetus’ sufferance. As for pharmacological management, some studies recommend treatment with low-dose aspirin or heparin for prevention of SGA, which is still controversial and there is lack of high-quality evidence of using aspirin or heparin for the prevention of fetal growth restriction. Plus, heparin combined with aspirin for the prevention of fetal growth restriction is currently under investigation.
- Participant
- We will include studies performed on gestating women at diagnosed risk of FGR, including: • history of late pregnancy loss or FGR • history of recurrent pregnancy loss (define by 3 or more consecutive first trimester spontaneous abortions) Other risk factors for FGR reported by the clinicians as present in the cohort of women in the retrieved studies, will be evaluated case by case for possible inclusion. No restriction on maternal age will be applied.
- Animal
- Human Disease Modelled
- Intervention
- Low-molecular-weight heparin (LMWH) combined with aspirin or acetylsalicylic acid. There will be no restriction in the pregnancy week of beginning of the therapeutic intervention.
- Comparator Control
- We will consider studies comparing the effect of LMWH combined with aspirin versus placebo, or no treatment, or versus heparin alone, or low-molecular-weight heparin alone, or aspirin alone.
- Main Outcome
- We will include only studies evaluating the primary efficacy outcome, i.e., FGR. As the definition of FGR is based on biometric measures not always reported in details in published studies, we will accept the diagnosis of FGR provided by the authors of the studies.
- Outcome Measure
- Additional Outcome
- The following secondary efficacy outcomes will be considered (when reported): • Preterm birth, defined as a delivery before completing 37 weeks of gestation. • Fetal or neonatal death , including the events related to early or late pregnancy loss, and perinatal and early neonatal death. As for safety outcomes, we will consider any side effect experienced by treated women or by fetuses or newborns in included studies; side effects will be defined based on authors’ definitions. In addition, in studies reporting the primary outcome, all maternal adverse events (such as pre-eclampsia, placental abruption, exc.) will be evaluated.
- Study Method
- Intervention, Systematic review
- Keyword
- Aspirin; Female; Fetal Growth Retardation; Heparin, Low-Molecular-Weight; Humans; Incidence; Pre-Eclampsia
- Contact
- Hao Wen [email protected]
- Organisational Affiliation
- Guangzhou Women and Childrens Medical Center
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- China
- Review Stage
- Review Ongoing
- First Submission Date
- 2023-07-18
- Registration Date
- 2023-07-28
- Anticipated Start Date
- 2023-08-01
- Anticipated Completion Date
- 2024-08-01
- Title Cn
- 低分子肝素联合阿司匹林预防胎儿生长受限：系统评价与Meta分析
- Title En
- Low Molecular Weight Heparin Combined with Aspirin for the Prevention of Fetal Growth Restriction: a systematic review and meta-analysis
- Bilingual Status
- complete