Cochrane Reviews have found modest benefit for antiplatelet drugs, chiefly low-dosage aspirin, to include what reductions?

• A. 8% reduction in preterm birth, 10% reduction in small for gestational age infants, and 14% reduction in fetal or neonatal deaths
• B. 2% reduction in preterm birth, 5% reduction in SGA infants, and 7% reduction in fetal or neonatal deaths
• C. 15% reduction in preterm birth, 15% reduction in SGA infants, and 15% reduction in fetal or neonatal deaths
• D. No effect on preterm birth or fetal outcomes

Answer: (A)

Low-dose aspirin as an antiplatelet therapy in pregnancy shows small but consistent reductions in adverse perinatal outcomes. Cochrane Reviews pooling randomized trials indicate about an 8% reduction in preterm birth, a 10% reduction in small-for-gestational-age infants, and a 14% reduction in fetal or neonatal deaths. These figures reflect modest relative risk reductions achieved when aspirin is started in pregnancy, typically in those at higher risk for placental insufficiency or preeclampsia.

The other patterns of effect—either smaller reductions, larger uniform reductions, or no effect—do not align with the aggregated trial data. The key takeaway is that while the benefits are modest, they are meaningful across these outcomes when low-dose aspirin is used appropriately.