NIHR Signal: – Starting daily low-dose aspirin before 16 weeks of pregnancy in women at risk reduces pre-eclampsia, severe pre-eclampsia and foetal growth restriction. Aspirin started after 16 weeks is less beneficial, giving smaller risk reduction for pre-eclampsia and no effect on other outcomes. Defining who is ‘at risk’ remains challenging.
Pre-eclampsia is a rare pregnancy complication, but one that can be dangerous for both mother and baby. Pregnant women are screened for pre-eclampsia risk factors at the antenatal booking appointment. NICE recommend women identified to be at risk are given preventative treatment with 75mg of aspirin from 12 weeks onwards.
This large systematic review assessed doses between 50 and 150mg daily and suggests the higher of these low dose options started before 16 weeks may be better than the very low (60mg) doses. Most studies assessed 100mg or 60mg doses; 100mg aspirin was effective, whereas 60mg was not. Only two small studies assessed the recommended 75mg but it was effective. Aspirin is readily available and a cheap drug.
The findings require confirmation in larger trials that directly compare different doses.
Read the full Signal here