Evidence mapPaperPMID 41345838Full record

ArticleBMC pregnancy and childbirth2025

Network meta-analysis: comparative efficacy of diverse aspirin dosages and heparin in mitigating placenta-mediated pregnancy complications.

Zhihui Xiong, Shenglin Jiang, Zhouhui Yuan, Lijie Li, Yunmeng Chen

Abstract readComparative StudyNetwork Meta-Analysis
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Zhihui XiongObstetrical Department, Zhejiang Hospital, Hangzhou, 310007, China.
Shenglin JiangObstetrical Department, Zhejiang Hospital, Hangzhou, 310007, China.
Zhouhui YuanObstetrical Department, Zhejiang Hospital, Hangzhou, 310007, China.
Lijie LiObstetrical Department, Zhejiang Hospital, Hangzhou, 310007, China.
Yunmeng ChenObstetrical Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. chenymhaha@163.com.

Funding

Basic public welfare research program of Zhejiang Province, China LGF20H040003
6 · The paper itself

Abstract

objectiveThis study aimed to assess the comparative efficacy of different low-dose aspirin (ASA) dosages, either alone or in combination with heparin, in preventing placenta-mediated pregnancy complications (PMPC) among high-risk pregnant women using a network meta-analysis (NMA).

methodsPubMed, Embase, Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCTs) up to August 15, 2025. Studies evaluating ASA (< 100 mg/day, ≥ 100 mg/day), unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), and their combinations in high-risk populations were included. Data from 63 RCTs (20,325 participants) were analyzed using Bayesian random-effects NMAs and trial sequential analysis (TSA).

resultsAll anticoagulant regimens significantly reduced preeclampsia (PE) risk by 24–95% compared to placebo/no treatment. The combination of < 100 mg/day ASA + LMWH notably decreased severe PE (odds ratio [OR] = 0.05, 95% confidence interval [CI] = 0.00–0.59) and miscarriage and stillbirth or perinatal death (OR = 0.50, 95% CI = 0.32–0.77). TSA confirmed that ≥ 100 mg/day ASA + LMWH significantly reduced PMPC risk. While LMWH alone showed efficacy in reducing placental abruption, combined regimens outperformed monotherapies in overall PMPC prevention. No significant differences in bleeding risk or neonatal outcomes (e.g., preterm delivery) were observed across regimens.

conclusionsAnticoagulant therapies, particularly combinations of ASA and LMWH, effectively mitigate PMPC. The < 100 mg/day ASA + LMWH regimen demonstrates optimal efficacy in reducing severe PE and fetal loss, while ≥ 100 mg/day ASA + LMWH is strongly supported by TSA. These findings inform clinical decisions for PMPC prophylaxis.

Indexed as

AnticoagulantsAspirinHeparinPlacenta DiseasesPregnancy ComplicationsAbortion, SpontaneousDrug Therapy, CombinationFemaleHeparin, Low-Molecular-WeightHumansPre-EclampsiaPregnancyRandomized Controlled Trials as TopicAnticoagulantsAspirinHeparinHeparin, Low-Molecular-WeightAspirinHeparinNetwork meta-analysisPlacenta-mediated pregnancy complicationsSample size

Identifiers

PMID41345838
PMCPMC12837239

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.