Aspirin May Prevent Pregnancy Complication

Preeclampsia risk in pregnancy may be lowered with aspirin

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Preeclampsia is a potentially dangerous pregnancy complication that can affect pregnant women and their babies. For women at high risk for the condition, low-dose aspirin may help stave it off.

An estimated 4 percent of pregnant women in the US get preeclampsia. It is marked by high blood pressure and excess protein in the urine. It can damage blood vessels, affect kidneys and other organs and cause preterm birth.

The US Preventive Services Task Force (USPSTF) has issued a recommendation for pregnant women who are at high risk for preeclampsia. This panel of health care experts urged these women to take low-dose aspirin to help prevent the problem.

"Check blood pressure regularly during pregnancy for signs of preeclampsia."

Despite the recommendation, low-dose aspirin to reduce preeclampsia risk is not standard practice among doctors just yet.

"I currently do not prescribe low-dose aspirin for patients that are considered at high risk for developing preeclampsia," said Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC. "This practice has not become standard of care as of yet, however, there is a growing body of evidence that supports its consideration for use in these circumstances, and I do believe that eventually it will become standard practice."

According to Dr. Hall, "The study in question is part of the ever growing body of evidence touting its benefits compared to what is a relatively low-risk profile of this additional medication."

Michael LeFevre, MD, vice chair in the Department of Family and Community Medicine at the University of Missouri School of Medicine in Columbia, is chair of the USPSTF.

Dr. LeFevre and colleagues on the task force reviewed the results from 28 studies of women with a high risk of preeclampsia.

High-risk factors for preeclampsia may include a family history of preeclampsia, a multiple pregnancy (carrying twins, triplets, etc.), being over age 35 and being obese. The Mayo Clinic says that chronic high blood pressure, migraines, type 1 or 2 diabetes, kidney disease, lupus and a tendency to develop blood clots can also increase the risk.

Most of the findings were based on two large studies. The Maternal-Fetal Medicine Units trial involved 2,503 US women at increased risk of preeclampsia. Patients in the treatment group were given 60 milligrams of aspirin. They were told to stop taking it if preeclampsia developed.

The Collaborative Low-Dose Aspirin Study in Pregnancy looked at 9,364 women. They had enrolled to prevent or treat preeclampsia. About 2 out of 3 of these patients began taking aspirin before 20 weeks of gestation (the time when the fetus is developing in the uterus). They took 60 milligrams of aspirin until the birth.

Based on pooled results for the studies, the USPSTF said women at high risk of preeclampsia could reduce their risk by about one quarter by taking low-dose aspirin.

Low-dose aspirin may lower the risk of preterm birth by 14 percent in these high-risk women, the authors found. Preeclampsia accounts for 15 percent of preterm births in the US.

The research team also said aspirin may reduce the risk of intrauterine growth restriction (IUGR) by 20 percent. IUGR refers to below-normal growth of the baby while it is in the womb.

The USPSTF said women at high risk for preeclampsia should take 81 milligrams of aspirin after 12 weeks of pregnancy. This is a common dose often taken to prevent heart attack or stroke.

The recommendation applies to women who do not show signs or symptoms of preeclampsia and haven’t had any health problems from using aspirin in the past. Patients should speak to their doctors before taking any new medicines.

The USPSTF published the recommendation Sept. 8 in Annals of Internal Medicine.

Review Date: 
September 8, 2014
Last Updated:
September 9, 2014