USPSTF recommends low-dose aspirin for women at high risk for preeclampsia

The US Preventive Services Task Force (USPSTF) published a final recommendation statement recommending that women at high risk for preeclampsia use low-dose aspirin (81 mg/day) after 12 weeks of pregnancy to prevent the condition and its related health problems.

This is a B recommendation. This recommendation applies to pregnant women who are at high risk for preeclampsia, who do not show signs or symptoms of the condition, and who can safely take aspirin.

“The evidence shows that there are a number of risk factors that put a woman at high risk for developing preeclampsia,” said Task Force member Jessica Herzstein, MD, MPH.

While preeclampsia during a previous pregnancy is the strongest risk factor, there are a number of chronic conditions that also put women at high risk, including chronic high blood pressure, diabetes, and autoimmune diseases, according to Dr Herztein.

“For women at high risk, we determined that low-dose aspirin helps prevent preeclampsia and the benefits outweigh the risk of harms,” she said. “Women should speak with their prenatal clinician about their level of risk for developing preeclampsia and discuss potential benefits and harms of taking aspirin based on their individual health situation.”

The prior guideline from 1996 concluded that there was insufficient evidence to determine whether the benefits of aspirin therapy during pregnancy outweigh the harms.

“We reviewed the evidence from additional studies done since then and concluded that daily low-dose aspirin taken by pregnant women at high risk for preeclampsia improves health outcomes for the mother and the baby,” Dr Herzstein said. 

The current recommendation for low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia is similar to the recommendations of other groups, including the American College of Obstetricians and Gynecologist, World Health Organization, and National Institute for Health and Clinical Excellence. 

The Task Force does not recommend one brand of aspirin over another, and it looked at the entire body of evidence on the effectiveness of low-dose aspirin prescribed in the primary care setting to prevent preeclampsia, according to Dr Herzstein.

“Evidence that the Task Force looked at to develop this recommendation may be of interest to formulary managers,” she said.

In particular, the Task Force found that, for women at high-risk of preeclampsia, daily low-dose aspirin during pregnancy reduced the risk of preeclampsia by 24%, premature birth (birth of a baby before 37 weeks of pregnancy) by 14%, and intrauterine growth restriction (when the baby grows slower than expected in mother’s womb by 20%).

This recommendation has been published online in the Annals of Internal Medicine.

Related:

USPSTF: Some pregnant women should take low-dose aspirin to prevent pre-eclampsia