As­pirin ad­vised for women at high risk for preg­nancy com­pli­ca­tion

Daily Trust - - HEALTH -

Preg­nant women at high risk for the se­ri­ous con­di­tion called preeclamp­sia should take low­dose as­pirin ev­ery day af­ter their first trimester, ac­cord­ing to a new draft rec­om­men­da­tion by an in­flu­en­tial U.S. panel of ex­perts.

Daily low-dose as­pirin (81 mil­ligrams) in mid­dle and late preg­nancy can sig­nif­i­cantly re­duce the oc­cur­rence of preeclamp­sia among these women. And it can lower the risk of preterm birth or low birth weight re­sult­ing from the preg­nancy-re­lated con­di­tion, ac­cord­ing to the rec­om­men­da­tion by the U.S. Pre­ven­tive Ser­vices Task Force.

“Preeclamp­sia is one of the more com­mon causes of se­ri­ous health prob­lems for both the ex­pec­tant mother and their baby,” said Dr. Michael LeFevre, chair­man of the task force, and vice chair of fam­ily and com­mu­nity medicine at the Univer­sity of Mis­souri School of Medicine. “At least for preg­nant women at high risk for preeclamp­sia, a low dose of as­pirin taken daily can help pre­vent the con­di­tion and im­prove the out­come for both mother and child.”

The ev­i­dence re­view upon which the rec­om­men­da­tions are based was pub­lished on­line April 7 in the jour­nal An­nals of In­ter­nal Medicine.

Preeclamp­sia is a com­plex con­di­tion that oc­curs in preg­nant women and in­volves an in­crease in blood pres­sure and ex­cess protein in the urine af­ter 20 weeks of preg­nancy. About 4 per­cent of all preg­nan­cies in the United States are af­fected by preeclamp­sia, ac­cord­ing to in­for­ma­tion from the jour­nal.

It’s im­por­tant to pre­vent preeclamp­sia be­cause the only treat­ment once it takes hold is de­liv­ery, which can pose risks to the baby if per­formed be­fore 34 weeks of ges­ta­tion. Preeclamp­sia is re­spon­si­ble for more than one-third of the se­ri­ous health prob­lems that oc­cur among preg­nant women, and 15 per­cent of preterm births, the jour­nal noted.

Preg­nant women who con­tract preeclamp­sia can suf­fer po­ten­tially life-threat­en­ing or­gan dam­age or stroke. Un­born fe­tuses grow too slowly as the con­di­tion robs them of oxy­gen and nu­tri­ents, leading to low birth weight ba­bies, preterm birth or still­birth, the re­searchers ex­plained.

“The baby grows too slowly, so you get a small baby, or you have to deliver the baby early to save the mother’s life be­cause it can lead to stroke,” said Jil­lian Hen­der­son, lead au­thor of the ev­i­dence re­view and an in­ves­ti­ga­tor at the Kaiser Per­ma­nente Cen­ter for Health Re­search in Port­land, Ore.

LeFevre said women at high risk of preeclamp­sia in­clude those in the fol­low­ing cat­e­gories:

Have had preeclamp­sia pre­vi­ous preg­nan­cies,

Have high blood pres­sure or di­a­betes prior to preg­nancy,

Are hav­ing twins, triplets or even more in a multi-birth preg­nancy.

A doc­tor also might rec­om­mend daily as­pirin use in women who have a com­bi­na­tion of two or more mod­er­ate risk fac­tors, LeFevre said.

in These in­clude women who are:

Hav­ing their first baby, obese, older than 35 or black.

Daily low-dose as­pirin use re­duced the risk of preterm birth by 14 per­cent and of slow fe­tal growth by 20 per­cent, ac­cord­ing to the new re­view of the lat­est med­i­cal data. And it led to a 24 per­cent re­duc­tion in the over­all oc­cur­rence of preeclamp­sia, the re­view found.

In ad­di­tion, there’s no ev­i­dence of po­ten­tial harm in daily low-dose as­pirin use for preg­nant women at high risk of preeclamp­sia, study au­thor Hen­der­son said.

How­ever, any ex­pec­tant mother should con­sult with her doc­tor be­fore be­gin­ning a daily as­pirin reg­i­men, LeFevre added.

“We cer­tainly don’t want women to go out and start tak­ing low-dose as­pirin with­out talk­ing with their pre­na­tal provider about whether they are at high enough risk to be­gin tak­ing as­pirin,” he said. “This is not some­thing women should do on their own. This is some­thing they should do in con­sul­ta­tion with their health care provider.”

The U.S. Pre­ven­tive Ser­vices Task Force is an in­de­pen­dent, vol­un­teer panel of na­tional ex­perts that makes ev­i­dence-based rec­om­men­da­tions about pre­ven­tive med­i­cal ser­vices such as health screen­ings, coun­sel­ing and med­i­ca­tions.

The draft rec­om­men­da­tion on as­pirin treat­ment for preeclamp­sia has­been­post­ed­for­pub­lic­com­men­tat­pre­ven­tiveser­vices­task­force. org. Com­ments can be sub­mit­ted from April 8 to May 5.

Hen­der­son said the new re­view echoes ear­lier re­search and ev­i­dence re­views that have sup­ported low-dose as­pirin to pre­vent preeclamp­sia in high-risk moth­ers.

“It’s not a big dif­fer­ence from what’s been found ear­lier,” she said.

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