Extensive study offers ‘definitive proof’ of improved outcomes in high-risk pregnancies
Taking a low-dose aspirin before bed can reduce the risk of pre-eclampsia, which can cause premature birth and, in extreme cases, maternal and fetal death.
Pre-eclampsia is characterized by an increase in blood pressure and protein in the urine, which can occur after the 20th week of pregnancy. It causes reduced placental blood flow, restricting the flow of oxygen and nutrients to the fetus. It often contributes to health complications for the baby including growth restriction, pre-term birth, or even death. It can lead to convulsions (eclampsia), renal or liver failure, cardiac, pulmonary and other maternal health complications.
A trial, led by Professor Kypros Nicolaides of Fetal Medicine at King’s College London, Dr. Liona Poon of King’s College London, with Professor David Wright of the University of Exeter, found that administering low-dose aspirin (150 mg) per day to pregnant women from between 11 to 14 weeks of pregnancy up until 36 weeks, led to a 62% reduction in the rate of pre-term preeclampsia.
The double-blind, placebo-controlled trial of 1,776 women at high risk for pre-term preeclampsia found a lower incidence of developing the disease in women taking aspirin than those taking a placebo. Pre-term preeclampsia occurred in 13 participants (1.6%) in the aspirin group, compared to 35 (4.3%) in the placebo group. The results prompted calls for low-dose aspirin to be routinely prescribed to women at risk of the disease.
An analysis of more than 30 trials investigating the benefit of a dose of 50 to 150 mg of aspirin per day showed that such prevention therapy resulted in a 10% lower incidence of preeclampsia.
The World Health Organization already recommends low-dose aspirin started before 20 weeks of pregnancy for the prevention of pre-eclampsia of high-risk women.
In the United States, the American College of Obstetricians and Gynaecologists recommends the use of aspirin in women with a history of pre-eclampsia in more than one pregnancy or a history of pre-eclampsia resulting in delivery before 34 weeks of gestation.