1 results for Askie, LM

  • Paris Collaboration: Antiplatelets to Prevent Pre-Eclampsia: a Review Using Individual Patient Data - Infant Outcomes.

    Henderson-Smart, DJ; Askie, LM; Duley, L; Stewart L; Showell, Marian (2006)

    Conference item
    The University of Auckland Library

    PARIS Collaboration: antiplatelets to prevent pre-eclampsia: a review using individual patient data (IPD) - infant outcomes. Henderson-Smart DJ (1), Askie LM (2), Duley L (3), Stewart L (4), Showell M (1), on behalf of the PARIS Collaboration. (1) Centre for Perinatal Health Services Research, University of Sydney, Australia; (2) NHMRC Clinical Trials Centre, University of Sydney, Australia; (3) Resource Centre for Randomised Trials, University of Oxford, UK; (4) Medical Research Council Clinical Trials Unit, London, UK Background: Antiplatelet agents, principally low dose aspirin, have been shown to confer small to moderate reductions in baby death and preterm delivery for women at risk of pre-eclampsia (Cochrane Systematic Review of 51 trials, 36,500 women). To understand more about how to target antiplatelet therapy to maximise benefit for these babies, we conducted a systematic review and series of meta-analyses using data from individual women and babies in each trial. This abstract presents results for the babies. Methods: Randomised trials comparing antiplatelet/s with placebo or no antiplatelet, during pregnancy, were included. Participating trialists joined the PARIS (Perinatal Antiplatelet Review of International Studies) Collaboration. This group developed and agreed a protocol, specifying the dataset to be collected and meta-analysis plan. Data were obtained for individual women and infants and checked thoroughly. Outcome and subgroup definitions were applied consistently across trials. The main baby outcomes were fetal/infant death to discharge, pre-term birth and small for gestational age. Several other measures of infant morbidity were also investigated. Primary analyses used individual babies as the unit of analyses, and sensitivity analyses used pregnancy as the unit of analysis. IPD allowed more powerful sub-group analyses than are possible with aggregate data, including gestation at randomisation and various maternal risk factors. Triallevel characteristics including type of antiplatelet and dose were also investigated. Sensitivity analyses explored trial size, quality, and method of defining pre-eclampsia. Results: IPD were obtained and analysed for 36 trials (36,488 infants), representing 90% of the worldwide randomised data addressing this question. Conclusions: Results, which will provide the most comprehensive and reliable assessment of the use of antiplatelet agents in the prevention of pre-eclampsia and its complications, will be discussed within the PARIS Collaborative Group in June 2006 and presented publicly for the first time at ISSHP 2006.

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