Patient or population: Pregnant women at any gestational age at high risk of developing hypertensive disorders in pregnancy Settings: Hospital setting Intervention: Antiplatelet agents, anticoagulants, antioxidants, calcium, nitric oxide, and their combinations Comparator: Placebo or no treatment Outcome: Preeclampsia | ||||||||
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Total studies: 77 RCTs Total participants: 93,234 | Direct estimates RR (95% CI) | Certainty of evidence | Indirect estimates RR (95% CI) | Certainty of evidence | Network estimates RR (95% CI) [95% PrI] | Certainty of evidence | SUCRA | Comments |
Antiplatelets + calcium (1 RCT; 334 participants) | 0.16 (0.03 to 0.75) | ⊕⊕⊝⊝ Lowa,b | 0.45 (0.05 to 4.06) | ⊕⊕⊕⊝ Moderateb | 0.19 (0.04 to 0.86) [0.04 to 1.01] | ⊕⊕⊝⊝ Lowa,b | 89.9% | There was no evidence of inconsistency for global inconsistency test (P = 0.459) and Dias’s inconsistency tests of the node splitting |
Anticoagulants + antiplatelets + calcium (2 RCTs; 156 participants) | Not estimable | 0.24 (0.03 to 1.79) | ⊕⊝⊝⊝ Very lowc,d | 0.24 (0.03 to 1.79) [0.03 to 2.07] | ⊕⊝⊝⊝ Very lowc,d | 78.3% | ||
Anticoagulants + antiplatelets (1 RCT; 20 participants) | 0.31 (0.07 to 1.27) | ⊕⊝⊝⊝ Very lowd,e | 0.46 (0.26 to 0.80) | ⊕⊕⊝⊝ Lowd | 0.43 (0.26 to 0.73) [0.19 to 1.01] | ⊕⊕⊝⊝ Lowd | 74.2% | |
Calcium + antioxidants (1 RCT; 660 participants) | 0.39 (0.16 to 0.96) | ⊕⊕⊝⊝ Lowe | 0.93 (0.18 to 4.82) | ⊕⊕⊕⊝ Moderateb | 0.47 (0.20 to 1.06) [0.16 to 1.35] | ⊕⊕⊕⊝ Moderateb | 66.8% | |
Calcium (13 RCTs; 26,021 participants) | 0.61 (0.46 to 0.80) | ⊕⊕⊕⊝ Moderatef | 0.69 (0.20 to 2.36) | ⊕⊕⊕⊝ Moderateb | 0.61 (0.47 to 0.80) [0.30 to 1.24] | ⊕⊕⊕⊝ Moderatef | 54.4% | |
Anticoagulants (2 RCTs; 399 participants) | 0.70 (0.28 to 1.79) | ⊕⊕⊕⊝ Moderateb | 0.23 (0.02 to 2.28) | ⊕⊕⊕⊝ Moderateb | 0.60 (0.25 to 1.43) [0.20 to 1.80] | ⊕⊕⊕⊝ Moderateb | 51.7% | |
Antiplatelets (31 RCTs; 41,953 participants) | 0.68 (0.57 to 0.82) | ⊕⊕⊝⊝ Lowa,f | 0.79 (0.27 to 2.33) | ⊕⊕⊕⊝ Moderateb | 0.69 (0.57 to 0.82) [0.35 to 1.35] | ⊕⊕⊕⊝ moderatef | 43.7% | |
Antiplatelets + nitric oxide (No direct comparison) | Not estimable | Not estimable | 0.80 (0.31 to 2.05) [0.25 to 2.55] | ⊕⊕⊝⊝ lowd | 34.5% | |||
Antioxidants (25 RCTs; 24,768 participants) | 0.76 (0.63 to 0.92) | ⊕⊕⊕⊝ Moderatef | 2.72 (0.27 to 27.33) | ⊕⊕⊕⊝ Moderateb | 0.77 (0.63 to 0.93) [0.39 to 1.52] | ⊕⊕⊕⊝ Moderatef | 32.3% | |
Nitric oxide (1 RCT; 68 participants) | 1.35 (0.61 to 3.01) | ⊕⊝⊝⊝ Very lowd,e | Not estimable | 1.35 (0.49 to 3.77) [0.39 to 4.65] | ⊕⊝⊝⊝ Very lowd,e | 11.4% |