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Impact of low-dose aspirin on maternal haemoglobin levels during pregnancy: a protocol for a systematic review and meta-analysis.

Created on 20 Jun 2026

Authors

Nokwethemba Monica Ngcobo, Vino Dorsamy, Chauntelle Bagwandeen

Published in

Systematic reviews. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

Aspirin, a cyclooxygenase (COX) inhibitor with anti-inflammatory and antiplatelet properties, is widely used during pregnancy to prevent preeclampsia (PE) and intrauterine growth restriction (IUGR). Despite its benefits, low-dose aspirin (LDA) has been linked to obstetric haemorrhage, including postpartum haemorrhage (PPH), and may influence haemoglobin (Hb) levels via its iron-chelating effects. The potential combined impact of LDA on Hb levels and pregnancy outcomes, however, remains unclear. This systematic review protocol aims to evaluate the effect of LDA on maternal Hb levels during pregnancy.
Following PRISMA-P guidelines, comprehensive searches will be conducted in PubMed, Cochrane Library, Embase, Scopus, Web of Science, and ClinicalTrials.gov, as well as grey literature sources. Eligible studies will include randomised controlled trials (RCTs), cohort studies, and case-control studies reporting Hb levels in pregnant women using LDA. Two independent reviewers will perform screening, data extraction, and quality appraisal. Data will be synthesised using meta-analysis where feasible, with subgroup analyses to explore heterogeneity, and narrative synthesis for studies not suitable for pooling.
The systematic review will generate pooled evidence on how LDA affects maternal Hb levels and associated pregnancy outcomes such as PE and fetal growth.
The findings may assist in refining clinical recommendations for LDA use in pregnancy by balancing its preventive benefits with potential risks related to anaemia, and haemorrhage.
PROSPERO CRD42024556220.

PMID:
42321907
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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