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Aspirin in Pregnancy, Is it Safe?

Since the 1980's asprin has been considered a safe option for women at high risk of pre-eclmapsia. ACOG has made it a standard of care to treat any pregnant woman who has a higher risk for pre-eclampsia with a low dose aspirin in pregnancy starting at the beginning of pregnancy. This nation wide initiative has encouraged many women to consider the use of asprin in pregnancy, but what are the risks?

What is Pre-Eclampsia and how is it caused?

Preeclampsia is a serious illness that results with high blood pressure, high levels of protien in their urine, and other organ invovlement. Preeclampsia usually develops after the 20th week of pregnancy. Preeclampsia is a condition unique to pregnancy that complicates between 5% and 8% of all births in the United States. It’s also the cause of about 15% of preterm deliveries (delivery before 37 weeks of pregnancy) in the U.S.

There are many thoughts as to what causes pre-eclampsia, but there is no set reason at this time. Theory suggest it is narrowing of the vessles in the placenta, it could be a reaction to sperm, or that it could be abnormal growth of the placenta.




Who is at risk for Pre-Eclampsia?

Women who are at higher risk for developing pre-ecampsia may also have other co-factors such as:

  • Women who have chronic high blood pressure or kidney disease before pregnancy

  • Women with high blood pressure or preeclampsia in an earlier pregnancy

  • Women who are obese

  • Women older than 40

  • Multiple gestation (being pregnant with more than one baby)

  • Women of African American ethnicity

  • Family history of preeclampsia

  • Women who suffer from frequent migraines

  • Women with diabetes

  • Women who have rhumatoid arthritis

  • Women who have lupus

  • Women who have scleroderma

  • Women diagnosed with polycystic ovarian syndrome

  • Women who have sickle cell disease


Why is Aspirin recommended?

According to ACOG using a low does aspirin in the first trimester and throughout pregnancy has prevented or delayed the onset of pre-eclampsia. ACOG states that low dose asprin is safe and reduces maternal and fetal complications in high risk women.


Is Aspirin really safe in pregnancy?

Despite ACOG's recommendation, there has been much research that has produced other potential concerns with the use of aspirin. For women, aspirin in the first trimester may lead to pregnancy loss, provided too close to delviery can increase the risk of postpartum hemorrohage. Hemorrohage is the number one compication of labor. Hemorrhage accounts for the highest mortality and morbidity rate for women.


Studies found that use of aspirin in the first trimester of pregnancy was associated with a statistically significant increased risk of overall congenital malformation. The increased the risk of congenital malformation include:

ventricular and atrial septal defects, endocardial cushion defects orofacial clefts, pulmonary hypertension of the newborn, gastroschisis, cardiac malformation, aortic stenosis, coarctation, hypoplastic left ventricle, transposition of the great arteries. conotruncal defects, neural tube defect;,cleft lip with or without cleft palate, and posterior cleft palate

Aspirin may also cause kidney damage, lower levels of amniotic fluid, and bleeding in the brain in preterm infants.

Are there alternatives to Aspirin?

Always speak with your health provider concerning any medication or condition.


Yes! There is an alternative to aspirin. Studies show that a 15% increase of omega-3 and omega-6 fatty acids are associated with a 46% reduction in risk of pre-eclampsia. This is over a 300% improvement relative to aspirin. Additonally, studies confirmed that the consumption of fish oil in pregnancy can increase birth weight and reduce the risk of preterm delivery.







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