Could early aspirin prophylaxis prevent against preterm birth?

A growing body of evidence suggests that defective placentation may play a major role in the genesis of preterm birth, indicating that preeclampsia, intra-uterine growth restriction (IUGR), and spontaneous preterm birth can share a similar mechanism of disease. A recent meta-analysis of low-dose aspirin trials for the prevention of preeclampsia and IUGR in high-risk women demonstrated that, when started early in gestation, aspirin could prevent more than half of preeclampsia and IUGR cases but was also linked with a significant decrease of preterm births (relative risk 0.22, 95%% confidence interval: 0.10--0.49). Unfortunately, most studies did not report specific data on the cause of preterm deliveries and, therefore, we could not estimate the proportion of this effect that could be related to spontaneous preterm births. Therefore, we hypothesize that low-dose aspirin could become an additional weapon in the prevention of preterm births and we suggest that further studies should be performed in this area of research.