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Preeclampsia: Low-Dose Aspirin May Prevent Poor Outcomes

Daily low-dose aspirin starting as early as the second trimester of pregnancy appears to prevent morbidity and mortality from preeclampsia among high-risk women, according to a systematic review published online April 8 in the Annals of Internal Medicine. However, potential rare or long-term harms could not be ruled out.

Preeclampsia, which is characterized by hypertension and proteinuria during the second half of pregnancy, is a leading cause of maternal and perinatal death.

“Previous comprehensive systematic reviews have found antiplatelets (primarily low-dose aspirin) to be beneficial for the prevention of preeclampsia among women at heightened risk. We conducted this systematic review to support the US Preventive Services Task Force [USPSTF] in updating its 1996 recommendation, which is no longer active.”

Poor perinatal health outcomes linked to preeclampsia may result from increased risk for intrauterine growth restriction or preterm delivery. Preeclampsia accounts for more than one third of serious maternal morbidities and 15% of preterm births. Conditions associated with higher risk for preeclampsia include a history of preeclampsia in a previous pregnancy or chronic conditions including diabetes, hypertension, and kidney disease.

The only effective treatment is delivery, which puts the infant at significant risk if gestational age is less than 34 weeks. Prevention of preeclampsia is therefore necessary to improve outcomes.

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