Is It Ok to Take Baby Aspirin While Pregnant

The US Preventive Services Task Force (USPSTF) has recently published recommendations on using aspirin during pregnancy to prevent preeclampsia and preeclampsia-related complications.

Preeclampsia is a serious condition that causes high blood pressure during pregnancy. It can begin during the second half of pregnancy, during labor, or shortly after delivery. In addition to high blood pressure, preeclampsia can cause problems with the kidneys, liver, and sometimes the eyes and brain. Some individuals with preeclampsia have more protein than normal in their urine. Preeclampsia also leads to poor growth of an infants in the womb, resulting in intrauterine growth restriction (IUGR) or small-for-gestational-age (SGA) infants. Symptoms of preeclampsia can include headaches, changes in vision, abdominal pain, or swelling of the legs.

Some risk factors for preeclampsia include a history of preeclampsia during a previous pregnancy, high blood pressure before pregnancy, diabetes before pregnancy, chronic kidney disease, some autoimmune diseases, and having a twin or triplet pregnancy.

Prevention of preeclampsia is important because once it occurs, the only cure is to deliver the infant. If it is too early in the pregnancy for delivery, some individuals are monitored and given medications to lower blood pressure and magnesium supplementation until their physician decides the time is right to deliver.

Aspirin is a medication that reduces inflammation. At low doses (such as 81 mg per day), it can also be a useful anticlotting agent by blocking the actions of platelets, blood cells that clump together to form clots in the blood. This can be useful for prevention of heart attack and stroke. However, it can also cause the side effect of unwanted bleeding, especially at higher doses.

What Is the Patient Population Under Consideration for Using Aspirin to Prevent Preeclampsia?

This recommendation applies to pregnant persons who are at high risk of preeclampsia and who have no previous side effects with low-dose aspirin or other medical conditions that increase the risk of bleeding.

What Are the Potential Benefits and Harms of Using Aspirin to Prevent Preeclampsia?

There is evidence from randomized trials that for individuals at high risk of preeclampsia, daily low-dose aspirin during pregnancy is effective in preventing preeclampsia as well as bad health outcomes associated with it, such as preterm birth, SGA or IUGR, and perinatal mortality.

The biggest potential harm of daily aspirin use is bleeding complications. However, randomized trials have shown that low-dose aspirin does not significantly increase serious bleeding complications such as placental abruption or postpartum hemorrhage in pregnant persons.

How Strong Is the Recommendation to Use Aspirin to Prevent Preeclampsia?

The USPSTF concludes with moderate certainty that there is a substantial net benefit of daily low-dose aspirin use to reduce the risk of preeclampsia, preterm birth, SGA, IUGR, and perinatal mortality in pregnant persons at high risk of preeclampsia.

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Article Information

Conflict of Interest Disclosures: None reported.

Source: US Preventive Services Task Force. Aspirin use to prevent preeclampsia and related morbidity and mortality: US Preventive Services Task Force recommendation statement. Published September 28, 2021. doi:10.1001/jama.2021.14781

Is It Ok to Take Baby Aspirin While Pregnant

Source: https://jamanetwork.com/journals/jama/fullarticle/2784505

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