Who should consider low-dose aspirin to prevent preeclampsia?

Aspirin has a long-standing reputation of effectively reducing the risk of heart attack and stroke in older adults. Now aspirin officially has a place in pregnancy health as well – taking it might be one of the only effective ways to prevent preeclampsia, a pregnancy complication characterized by high blood pressure.

In June 2018, the American Congress of Obstetrics and Gynecologists (ACOG) recommended that pregnant women who are at high risk for preeclampsia should take low-dose aspirin every day from about 12 weeks of pregnancy through delivery. When we say low-dose aspirin, we mean 80 to 150 mg a day, which is less than half the dose a person would take daily to reduce the risk of a stroke or heart attack (325 mg). 

ACOG also suggests that aspirin therapy be considered for women who have even one moderate risk factor for preeclampsia, such as:

• High blood pressure before pregnancy

• A current pregnancy with twins, triplets, or high-order multiples

• A personal or family history of preeclampsia

Preeclampsia facts that women need to know

The condition can cause severe maternal and fetal complications. Sadly, high blood pressure is among the highest causes of maternal death in Texas. The only “cure,” so to speak, is delivery of the baby and placenta, which sometimes means the baby has to be delivered prematurely to minimize maternal and infant complications.

Once a woman has preeclampsia, her risk of developing it in future pregnancies is 15 to 20 percent or greater, depending on the time and severity of her prior diagnosis. Previously, aspirin was recommended only to pregnant women with a history of preeclampsia – but the condition occurs in as many as 3 to 5 percent of pregnancies, and we know today that aspirin can be effective for a broader pool of women.

How can aspirin help reduce the risk of preeclampsia?

Preeclampsia is thought to be related to an inflammatory reaction within the blood vessels that connect to the placenta – the tissue that nourishes the fetus in the womb. Aspirin can inhibit the inflammatory response, thereby potentially preventing preeclampsia. While full-strength aspirin poses risks with long-term use, such as intestinal or stomach bleeding, low-dose aspirin generally avoids these side effects while retaining the anti-inflammatory properties of the drug.

As with any over-the-counter or prescription medication, aspirin isn’t safe for every woman during pregnancy. Talk to your doctor about whether you are at risk for preeclampsia and how aspirin might benefit you.

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