ACOG Committee Opinion: low-dose aspirin use during pregnancy

  • Obstet Gynecol
  • 1 Jul 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • The American College of Obstetricians and Gynecologists (ACOG) released recommendations on the use of low-dose (81 mg/day) aspirin during pregnancy. 

Why this matters

  • Aspirin is a NSAID that inhibits prostaglandin biosynthesis.
  • Other healthcare organizations endorse the use of aspirin to prevent preeclampsia, including the WHO, the National Institute of Health, and the US Preventive Services Task Force.
  • Aspirin has not been shown to increase the risk for adverse fetal or neonatal effects.

Recommendations

  • Low-dose aspirin should be given to women at high risk for preeclampsia.
  • High-risk factors include history of preeclampsia, multifetal gestation, renal disease, autoimmune disease, type 1 or type 2 diabetes, and chronic hypertension.
  • Moderate risk factors include first pregnancy, maternal age >35 years, BMI >30, family history of preeclampsia, socioeconomic characteristics, and personal history factors.
  • Low-dose aspirin should be initiated between 12 and 28 weeks (optimally before 16 weeks) and continued daily until delivery.
  • Low-dose aspirin, in the absence of risk factors for preeclampsia, should not be used for history of stillbirth, prevention of intrauterine growth restriction, prevention of spontaneous preterm birth, and prevention of early pregnancy loss.

Study design

  • Literature review and ACOG Committee Opinion.
  • Funding: None.

Limitations

  • Recommendations may change.

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