TY - JOUR T1 - Associations between the timing and dosing of aspirin prophylaxis and term and preterm pre-eclampsia JF - BMJ Evidence-Based Medicine JO - BMJ EBM SP - 159 LP - 160 DO - 10.1136/bmjebm-2018-110931 VL - 23 IS - 4 AU - Lisa Askie AU - Lelia Duley Y1 - 2018/08/01 UR - http://ebm.bmj.com/content/23/4/159.abstract N2 - Commentary on: Roberge S, Bujold E, Nicolaides KH. Aspirin for the prevention of pretermand term preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol 2018;218:287–93.Aspirin prophylaxis during pregnancy has been estimated in a participant-level meta-analysis to reduce the risk of pre-eclampsia by 10%.1 Evidence-based guidelines recommend aspirin for high-risk women, usually 75 mg from 12 weeks’ gestation and if possible before 20 weeks.2 Despite decades of research, controversy remains regarding the optimal dose and timing of aspirin treatment to prevent pre-eclampsia.While a meta-analysis using individual participant data (IPD) concluded that the effect on pre-eclampsia is consistent regardless of whether treatment starts before or after 16 weeks,3 an aggregate data meta-analysis concluded that a lower dose of aspirin (<100 mg) started after 16 weeks has ‘modest or no impact’.4 Another recent IPD meta-analysis suggested a dose–response effect … ER -