In plain words
Low-dose aspirin prophylaxis means using a low-dose aspirin during pregnancy to lower the chance of . Preeclampsia is a pregnancy condition with high blood pressure and signs of stress on another organ, such as the kidneys or liver. Guidelines offer this aspirin to people with certain risk factors, such as a history of preeclampsia, chronic high blood pressure, diabetes, or kidney disease. Other factors add up, including being 35 or older, a first pregnancy, or a high . Guidelines describe starting it in the first half of pregnancy, ideally early. It is not offered to everyone, and it is not the same as using aspirin for pain. Whether to use it is a decision made with your provider, who knows your history. Ask your provider what your risk factors add up to.
The deeper version
Low-dose aspirin reduces the incidence of preeclampsia in people at increased risk, through inhibition of thromboxane A2 in the placenta and effects on placental vascular function. The US Preventive Services Task Force (Owens et al., JAMA, 2021) uses a risk framework. High-risk factors, including prior preeclampsia, multifetal gestation, chronic hypertension, pregestational diabetes, renal disease, and autoimmune disease, are weighed against moderate-risk factors such as nulliparity, obesity, and age 35 or older. Aspirin is recommended for people with one high-risk factor or two or more moderate-risk factors. ACOG Committee Opinion 743 (2018) recommends starting between 12 and 28 weeks, ideally before 16 weeks. The controversy concerns where the threshold for offering aspirin should sit, and whether the benefit in moderate-risk groups outweighs bleeding and adherence concerns.
Where it comes up
- High blood pressure and preeclampsiaPregnancy: Your Body
- Pregnancy at 35 and olderPregnancy: Your Body
- Gestational diabetesPregnancy: Your Body
- Weight gain in pregnancyPregnancy: Your Body
What mothers here say about low-dose aspirin prophylaxis
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Sources
- US Preventive Services Task Force — Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Recommendation Statement, JAMA, 2021
- American College of Obstetricians and Gynecologists — Committee Opinion No. 743: Low-Dose Aspirin Use During Pregnancy, 2018