What are the current recommendations regarding aspirin for the prevention of preeclampsia?

The results of a systematic review suggests that the use of low-dose aspirin is associated with a reduction in the relative risk of preeclampsia. There is no difference in effect whether low-dose aspirin is started before or after 20 weeks gestation [1].

As of this writing The Society of Obstetricians and Gynaecologists of Canada and the American College of Chest Physicians recommend low-dose aspirin throughout pregnancy, starting from the second trimester.

The National Institute for Health and Clinical Excellence (NICE) recommends women at high risk of pre-eclampsia should take 75 mg of aspirin daily from 12 weeks until the birth of the baby [4,5] .

• Women at high risk include: hypertensive disease during a previous pregnancy ,chronic kidney disease ,autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome , type 1 or type 2 diabetes and chronic hypertension
• In addition NICE recommends women with more than one moderate risk factor for pre-eclampsia should to take 75 mg of aspirin daily from 12 weeks until the birth of the baby. Moderate risk factors are: first pregnancy , age 40 years or older, pregnancy interval of more than 10 years , body mass index (BMI) of 35 kg/m2 or more at first visit , family history of pre-eclampsia multiple pregnancy.

REFERENCES

1. Duley L, et al., Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004659. PMID: PMID:17443552
2. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Society of Obstetricians and Gynaecologists of Canada (SOGC)Clinical Practice guideline. J Obstet Gynaecol Can. 2008 Mar;30(7):S
Available at : http://www.sogc.org/guidelines/documents/gui206CPG0803_001.pdf Accessed 7/12/2010
3. Bates SM, VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e691S-736S.PMID:PMID:22315276
4. Hypertension in pregnancy:the management of hypertensive disorders during pregnancy
August 2010 (revised reprint January 2011)
http://www.nice.org.uk/nicemedia/live/13098/50475/50475.pdf .Accessed 7/12/2012
5. NICE clinical guideline 107 – Hypertension in pregnancy: the management of
hypertensive disorders during pregnancy
Available at :http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf
Available at :http://www.nice.org.uk/nicemedia/live/13098/50475/50475.pdf Accessed 7/12/2012