Baby Aspirin: The Key to a Healthier Pregnancy?

June 27, 2024

Preeclampsia affects about one in 25 pregnant women in the U.S. The condition causes dangerously high blood pressure that can seriously harm both mother and baby.

But many women may not be aware that there’s a simple yet effective prevention tool in the form of low-dose or baby aspirin. When women who are at risk for preeclampsia take low-dose aspirin during their pregnancy they can decrease their odds of developing the condition, along with the complications that can result from it, says University Hospitals maternal fetal medicine physician Ellie Ragsdale, MD.

Who’s at Risk for Preeclampsia?

Preeclampsia is characterized by elevated blood pressure (hypertension) and excess protein in the urine. It increases the risk for maternal seizures, stroke and blood clots, as well as kidney and liver problems. One of the most severe forms of preeclampsia is called HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, which can cause hemorrhage and death. Preeclampsia can also affect placenta function, leading to poor fetal growth, low birth weight and preterm delivery.

Risk factors for preeclampsia include:

Chronic high blood pressure
Diabetes
Obesity
Kidney disease
Certain autoimmune diseases
Being at the beginning or the end of childbearing years (teens/age 35 and older)
Pregnant with multiples, such as twins or triplets
Preeclampsia in a prior pregnancy
Certain ethnicities, including African American and other women of color

How Can Low-Dose Aspirin Help?

Studies show that taking low-dose aspirin during pregnancy can reduce the risk of preeclampsia by up to 15 percent. It can also reduce the risk of premature delivery and intrauterine growth restriction by 20 and 18 percent respectively, as well as the risk of other preeclampsia complications.

Experts recommend women who are at an increased risk for preeclampsia take baby aspirin starting at 10–12 weeks gestation for maximum benefit. Generally, it is recommended that pregnant women take two baby aspirin daily (the equivalent of 162 milligrams) up until delivery.

Baby aspirin can also be used by women with a history of previous pregnancy complications such as intrauterine growth restriction or miscarriage. Dr. Ragsdale says even women who are considered low-risk for preeclampsia and other complications should consider taking baby aspirin, as it poses no known risk to mom or baby. The only pregnant women who should not use baby aspirin are those who have a known allergy to aspirin or other salicylate derivatives.

“Baby aspirin is inexpensive, available over the counter, and easy to obtain. There are few drawbacks and many potential benefits for pregnant women,” says Dr. Ragsdale.

Baby Aspirin Therapy Slowly Becoming More Mainstream

So why is baby aspirin therapy not more widely practiced in pregnancy? According to Dr. Ragsdale, the initial recommendation for baby aspirin in pregnancy came in the form of a United States Preventive Services Task Force (USPSTF) guideline in 2014. However, the adoption of any new therapy in pregnant women is a slow process. Some providers may not be screening patients appropriately for risk factors, or may be hesitant to recommend a therapy that they are unfamiliar with.

“The treatment has become more mainstream in the last five years as more providers begin to recognize its potential,” says Dr. Ragsdale.

She advises pregnant women to talk to their provider about baby aspirin therapy, regardless of risk factors: “Advocate for yourself and discuss your personal medical history with your obstetrics provider. Together, you can determine if baby aspirin therapy is right for you.”