Can a Tiny Pill Help Prevent a Serious Pregnancy Complication?

Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality. Although there are risk factors that can predict the likelihood of developing preeclampsia during pregnancy, many women with no risk factors develop the disease.  According to the Preeclampsia Foundation, “preeclampsia and related disorders such as HELLP syndrome and eclampsia are most often characterized by a rapid rise in blood pressure that can lead to seizure, stroke, multiple organ failure and death of the mother and/or baby.”  Researchers have studied a number of medications and supplements, such as calcium, to see if they might decrease the incidence and the severity of the condition.  Most of these studies led to dead-ends, with negative results.

Researchers for the U.S. Preventive Services Task Force did a meta-analysis of two large randomized controlled trials (RCTs) and 13 smaller RCTs of high-risk women, as well as 8 additional studies looking at average-risk women, to see if taking low-dose aspirin (baby aspirin, 83 mg) during pregnancy reduced the incidence of preeclampsia.  “Depending on baseline risk, aspirin use was associated with absolute risk reductions of 2% to 5% for preeclampsia, 1% to 5% for intrauterine growth restriction, and 2% to 4% for preterm birth . No significant perinatal or maternal harms were identified, but rare harms could not be ruled out.”  Preeclampsia increases a woman’s chance of suffering a stroke, and low-dose aspirin has also been shown to reduce the incidence of stroke in the general population.  While taking low-dose aspirin will not prevent all cases of preeclampsia, it has not been demonstrated to have negative side effects, and should be considered. For pregnant women, it is certainly worth a discussion with their care provider during pregnancy to see if taking a baby aspirin may be a good idea.  It may be more beneficial than that ubiquitous prenatal vitamin!