Aspirin in early pregnancy may help fight pre-eclampsia

Prescribing aspirin in early pregnancy could be key in the battle against pre-eclampsia, a study shows.

Aspirin in early pregnancy may help fight pre-eclampsia

By Sarah Slater

Prescribing aspirin in early pregnancy could be key in the battle against pre-eclampsia, a study shows.

New research carried out at University College Dublin and published in the British Medical Journal shows that women in Ireland are open to taking a low daily dose (75mg) of aspirin from early pregnancy to reduce their chances of developing the condition.

The current approach here of screening expectant mothers for pre-eclampsia after they show early signs of the condition may not offer the best outcome for mothers and babies.

It is widely accepted that low doses of aspirin can significantly reduce the early onset of pre-eclampsia during pregnancy, but few studies have assessed the acceptability of non-routine medications in pregnancy. The study findings offer an encouraging sign that women in Ireland at low risk of developing pre-eclampsia are willing to take preventive steps early in their pregnancies.

Fionnuala McAuliffe, one of the study authors, from UCD School of Medicine, is calling for a widespread randomised controlled trial to test the efficacy and safety of a universal low-dose aspirin approach.

"Our study investigated if women were open to taking a low daily dose [75mg] of aspirin from early pregnancy [11 weeks] and would continue to do so up until the third trimester,” said Prof McAuliffe, a consultant obstetrician and gynaecologist at the National Maternity Hospital and director of UCD Perinatal Research Centre.

We found that, when encouraged by their doctor to take a low-level daily dose of aspirin from 11 weeks until 36 weeks, the majority of women did so, at an average adherence rate of 90%.

The study, funded by the Health Research Board, the Mother and Baby Clinical Trials Network, and Perinatal Ireland, involved 546 pregnant women from across two Dublin-based maternity hospitals.

Pre-eclampsia affects one in 10 first-time pregnancies, and the warning signs can often go unnoticed, causing serious problems for mother and baby.

For the mother, it can lead to acute problems of the liver, kidneys, brain, and clotting system, and survivors of pre-eclampsia have increased risk of cardiovascular and metabolic diseases later in life.

A quarter of all babies born to mothers with pre-eclampsia are growth restricted and a third are born prematurely.

Pre-eclampsia usually occurs during the second half of pregnancy, from around week 20, and the only treatment is to induce labour and deliver the baby.

Another study carried out in 2017, based on pregnant women involved in the Screening for Pregnancy End Points project, found that complications from pre-eclampsia cost the HSE upwards of €9m a year, with postnatal care the largest contributor to these costs.

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