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If you have risk factors for preeclampsia, start a daily low-dose aspirin after 12 weeks of pregnancy

  • Moderate value
  • Evidence A
  • Buys life
  • For: Pregnant or trying
  • Costs a little
  • Takes minutes
  • Some willpower

In plain words

Preeclampsia is a kind of high blood pressure disorder in pregnancy. You are at high risk if you had it in a previous pregnancy, are carrying more than one baby, have chronic high blood pressure, had diabetes before pregnancy, or have kidney disease or an autoimmune disease. For high-risk women, one low-dose aspirin a day from 12 weeks lowers preeclampsia by about 15%, and premature birth and death of the baby around birth each by about 20%. Others should not take it on their own.

Cost

A few dozen CNY. One tablet a day, until delivery. The hard part is not forgetting any day.

What you get

The U.S. Preventive Services Task Force gives a grade B recommendation: for people at high risk of preeclampsia, start low-dose aspirin (81 mg/day) after 12 weeks of pregnancy to prevent it. Preeclampsia is a high blood pressure disease of pregnancy. Pooling several studies gives the following results; the 95% CI is the plausible range. Preeclampsia RR 0.85 (95% CI 0.75 to 0.95, 16 studies), about 15% lower. Premature birth RR 0.80 (95% CI 0.67 to 0.95, 13 studies), about 20% lower. Perinatal death RR 0.79 (95% CI 0.66 to 0.96, 11 studies), about 21% lower; perinatal death means death in the period around birth. Small for gestational age / intrauterine growth restriction RR 0.82 (95% CI 0.68 to 0.99, 16 studies), about 18% lower; this means the baby is growing smaller than expected for the number of weeks.

Notes

High risk includes: preeclampsia in a previous pregnancy, twins or other multiple pregnancy, and chronic high blood pressure. It also includes type 1 or type 2 diabetes before pregnancy, kidney disease, and autoimmune diseases such as systemic lupus erythematosus and antiphospholipid syndrome. If you are not in these groups, don't take it on your own. This drug needs a doctor's prescription; explain your medical history clearly at prenatal visits and let the doctor decide. What is sold in China is mostly 100 mg enteric-coated tablets; take it as the doctor directs.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. US Preventive Services Task Force (2021). Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication

Mentioned in

Translated from the Chinese original. Original book, section 27, tip 5. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer