Data and recommendations related to the use of low-dose aspirin in pregnancy come from multiple sources but most notably from the 2021 US Preventive Services Task Force Recommendation Statement on Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality.
​
Recommendations of this task force have led to continued and in some cases, expanded use of low-dose aspirin in pregnant people with various risk factors for preeclampsia and relatedly, for preterm birth given consistent findings that the use of low-dose aspirin after 12-weeks of gestation can contribute to a:
​​
-
"reduction in risk for preterm birth, SGA/IUGR (small-for-gestational-age birth, intrauterine growth restriction), and perinatal mortality in persons at increased risk for preeclampsia "
-
reduced risk for preeclampsia "which leads to improved maternal and perinatal outcomes".
​
This task force also found that aspirin use was associated with minimal side effects.
​
While not completely understood, it is thought that a reduction in inflammation may be one reason why low-dose aspirin has been shown to consistently reduce the risk of preeclampsia, preterm birth, and other outcomes in some pregnant people.
​
Taskforce recommendations include that low-dose aspirin treatment after 12-weeks of gestation be considered for use in a patient (under the care of a physician) if:
-
One or more of these "High" risk factors are present:
-
​History of preeclampsia, especially when accompanied by an adverse outcome
-
Multifetal gestation (twins or other multiples)
-
Chronic hypertension
-
Pregestational type 1 or 2 diabetes
-
Kidney disease
-
Autoimmune disease (ie, systemic lupus erythematous, antiphospholipid syndrom
-
Combinations of multiple moderate-risk factors
-
​​
-
Two or more of these "Moderate" risk factors are present ("Consider" if even one of these risk factors are present:
​​
-
​Nulliparity (hasn't given birth to child)
-
Obesity (ie, body mass index >30)
-
Family history of preeclampsia (ie, mother or sister)
-
Black persons (due to social, rather than biological, factors)
-
Lower income
-
Age 35 years or older
-
Personal history factors (eg, low birth weight or small for gestational age, previous adverse pregnancy outcome)
-
>10-year pregnancy interval
-
In vitro conception
​
Please talk to your prenatal provider to learn more about low-dose aspirin use in pregnancy.