The American College of Obstetricians and Gynecologists (ACOG) recommends low-dose aspirin (81 mg daily) for pregnant women who are at high risk for preeclampsia.

Here’s a breakdown of the recommendation and its rationale:

• Purpose:
  • Low-dose aspirin is used to reduce the risk of preeclampsia, a pregnancy complication characterized by high blood pressure and organ damage.
• High-Risk Factors:
  • ACOG identifies several risk factors that warrant low-dose aspirin therapy. These include:
    • History of preeclampsia, particularly with adverse outcomes.
    • Multifetal gestation (twins, triplets, etc.).
    • Chronic hypertension.
    • Pre-gestational diabetes.
    • Kidney disease.
    • Autoimmune diseases (e.g., systemic lupus erythematosus, antiphospholipid syndrome).
• Rationale:
  • Preeclampsia is thought to be related to abnormal placental development and function.
  • Low-dose aspirin helps to prevent preeclampsia by inhibiting platelet aggregation and promoting healthy blood flow to the placenta.
  • The goal is to reduce the risk of the development of preeclampsia, especially early onset preeclampsia, which is the most severe form.
• Timing:
  • ACOG recommends initiating low-dose aspirin therapy between 12 and 28 weeks of gestation (ideally before 16 weeks) and continuing it daily until delivery.
• Important Considerations:
  • The decision to prescribe low-dose aspirin should be made on an individual basis after a thorough risk assessment.
  • Women should discuss the risks and benefits of aspirin therapy with their healthcare provider.
  • It is very important that the patient does not begin taking aspirin without the explicit direction of their doctor.