From the Guidelines
Low-dose aspirin during pregnancy is recommended for women with chronic hypertension, a previous history of preeclampsia, or other conditions associated with heightened risk of preeclampsia, as it can significantly reduce the risk of preterm preeclampsia. The benefits of aspirin during pregnancy include preventing preeclampsia, a serious pregnancy complication characterized by high blood pressure and organ damage. According to a recent study published in Circulation 1, low-dose aspirin (75 to 100 mg daily) can reduce the absolute risk of preterm pre-eclampsia from 4.3% to 1.6% in high-risk patients.
The key benefits of aspirin during pregnancy can be summarized as follows:
- Reduces the risk of preterm preeclampsia by approximately 60% (relative risk of 0.57) 1
- Improves blood flow to the placenta and reduces inflammation
- Is well-tolerated, widely available, and highly cost-effective
- Should be initiated between 12 and 28 weeks of gestation, optimally before 16 weeks, and continued daily until delivery
It is essential to note that aspirin during pregnancy should only be taken under medical supervision, as it may increase bleeding risk and is not recommended for all pregnant women. Women should consult their healthcare provider before starting any medication during pregnancy to determine if aspirin is appropriate for their specific situation. Aspirin use during pregnancy is safe, and its benefits in preventing preeclampsia make it a valuable intervention for high-risk pregnancies 1.
From the Research
Benefits of Aspirin During Pregnancy
- Aspirin has been used during pregnancy to prevent or delay the onset of preeclampsia, with low-dose aspirin (81 mg/day) prophylaxis recommended in women at high risk of preeclampsia 2.
- The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the U.S. Preventive Services Task Force guideline criteria for prevention of preeclampsia, which includes the use of low-dose aspirin 2, 3.
- Aspirin has been proven efficient to prevent pre-eclampsia and fetal growth restriction in high-risk patients 4.
- The benefits of prescribing aspirin have been demonstrated for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia 2.
Safety and Risks of Aspirin During Pregnancy
- Daily low-dose aspirin use in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use 2.
- However, there is a risk of intracranial hemorrhage in pregnant women taking low-dose aspirin, although this is a rare event 5.
- The use of aspirin during pregnancy should be carefully considered and monitored, particularly in women with a history of bleeding disorders or other risk factors for hemorrhage 5, 6.
Guidelines for Aspirin Use During Pregnancy
- The U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine recommend the use of low-dose aspirin in pregnancy for preeclampsia prevention in those at high risk 2, 3, 6.
- There is general agreement among clinical practice guidelines on the indications for aspirin intake in pregnancy, including prior preeclampsia, chronic hypertension, autoimmune disease, and diabetes mellitus type 1 or 2 6.
- However, there is heterogeneity in the recommendations provided by different guidelines as regards the gestational age at which aspirin should be commenced, the dose, and the duration of therapy 6.