Table 2 Summary of findings for medications to prevent gestational hypertension
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: Gestational hypertension | ||||||||
|---|---|---|---|---|---|---|---|---|
Total studies: 39 RCTs Total participants: 60,953 | 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 |
Anticoagulants + antiplatelets (1 RCT; 20 participants) | 0.11 (0.007 to 0.50) | ⊕⊝⊝⊝ Very lowa,b | 0.31 (0.03 to 2.98) | ⊕⊕⊝⊝ Lowc | 0.21 (0.04 to 1.20) [0.03 to 1.39] | ⊕⊝⊝⊝ Very lowa,c | 90.1% | There was no evidence of inconsistency for global inconsistency test (P = 0.512) and Dias’s inconsistency tests of the node splitting |
Anticoagulants + antiplatelets + calcium (1 RCT; 149 participants) | Not estimable | Not estimable | 0.47 (0.13 to 1.74) [0.11 to 2.05] | ⊕⊕⊕⊝ Lowc | 73.1% | |||
Calcium (9 RCTs; 24,534 participants) | 0.77 (0.59 to 1.00) | ⊕⊕⊕⊝ Moderateb | 0.75 (0.22 to 2.53) | ⊕⊕⊕⊝ Moderateb | 0.78 (0.61 to 1.00) [0.43 to 1.39] | ⊕⊕⊕⊝ Moderateb | 53.6% | |
Antiplatelets (19 RCTs; 16,813 participants) | 0.78 (0.62 to 0.99) | ⊕⊕⊕⊝ Moderated | 1.41 (0.40 to 5.00) | ⊕⊕⊕⊝Moderateb | 0.80 (0.64 to 1.00) [0.44 to 1.41] | ⊕⊕⊕⊝ Moderateb | 51.2% | |
Antiplatelets + calcium (1 RCT; 334 participants) | 0.61 (0.22 to 1.68) | ⊕⊕⊝⊝ Lowb,d | 1.78 (0.24 to 12.92) | ⊕⊕⊕⊝ Moderateb | 0.70 (0.26 to 1.87) [0.22 to 2.22] | ⊕⊕⊝⊝ Lowb,d | 51.1% | |
Antioxidants (10 RCTs; 53,057 participants) | 1.06 (0.85 to 1.34) | ⊕⊕⊕⊝ Moderateb | Not estimable | 1.07 (0.85 to 1.34) [0.60 to 1.90] | ⊕⊕⊕⊝ Moderateb | 11.6% | ||