Summary: Low-dose aspirin daily, beginning around 12 weeks gestation, appears to reduce the preeclampsia risk in high-risk pregnant women, a high-profile government group said on Monday. In clinical trials, a single dose of aspirin on a daily basis reduced the likelihood of preeclampsia by 24 percent in high-risk women. But before you take any medications, including aspirin, be sure to talk to your doctor.
By Nancy Josephson Liff | Posted: April 8, 2014
A single aspirin taken once a day may prevent life-threatening preeclampsia in some high-risk women, according to an online article in the April 8 Annals of Internal Medicine. The article is based on findings from researchers at Kaiser Permanente Center for Health Research, in Portland, Oregon, who reviewed 23 studies that took place over an eight-year period ending in 2014.
Lead author Jillian T.Henderson, PhD., MPH, conducted the review, along with colleagues at Kaiser Permanente. "Our finding that something as simple as low dose aspirin can prevent preeclampsia among the women most likely to develop it is encouraging since there are few options for treatment and we still know so little about how it develops," Dr. Henderson stated.
The review now serves as the basis for a draft of U.S. Preventive Services Task Force recommendations for using low-dose aspirin to reduce at-risk women's chances of developing the disorder.
In the clinical trials, Oregon investigators said, the aspirin regimen cut chances of preeclampsia by 24 percent in high-risk women, including those who had preeclampsia in a previous pregnancy, anyone carrying multiples, and those who had high blood pressure or diabetes when they first got pregnant.
Investigators said the studies showed an aspirin a day also reduced the risk of premature birth by 14 percent and the risk of intrauterine growth restriction (IUGR) by 20 percent — a condition in which the fetus doesn't grow as fast as expected — compared with women taking a placebo.
Another plus: The aspirin regimen appeared to cause no short-term harm to moms and babies. A large trial followed infants to 18 months and did not find developmental differences in the aspirin-treated group. But investigators pointed out that long-term risks could not be ruled out and need to be studied further.
Preeclampsia is a pregnancy condition that's usually diagnosed after the 20-week mark, and is characterized by high blood pressure, protein in the urine, and other problems. While most cases resolve without issues, it can be dangerous for moms and babies as it may prevent little ones from getting enough blood and oxygen and can damage a mother's liver and kidneys. In rare cases it causes eclamptic seizures and stroke. The only way to resolve the condition is to deliver the baby.
In the U.S., preeclampsia marked nearly four percent of all deliveries in 2010; the rate of "severe" preeclampsia has increased over the past three decades. Perinatal mortality is nearly two times higher in pregnancies affected by pre-eclampsia, with about 12 percent of maternal deaths due to the disorder.
No one knows for sure what causes the problem, although a mother's immune system, obesity, polycystic ovary syndrome, and diabetes have all been implicated. Given these findings, the federal task force recently drafted recommendations for at-risk women to begin taking low-dose aspirin in the second trimester. The task force also advises that other pregnant women could benefit from aspirin if they have more than one moderate risk factors including obesity, a family history of the disorder, or advanced maternal age (considered 35 and up).
Although some mamas-to-be may already take aspirin under a doctor's supervision, it's yet not a widespread practice. If you don't have any risk factors some doctors may advise against taking aspirin during pregnancy — especially during the third trimester. So if you think low-dose aspirin therapy might be for you, be sure to talk to your health care provider and carefully follow all of her instructions.
Do you have a personal or family history of preeclampsia? Did anyone suggest you take low-dose aspirin daily?
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