Hypertension, or high blood pressure, can be a health risk for anyone. However, this condition is particularly dangerous for pregnant women and their unborn children. There is an even greater danger if gestational hypertension becomes a condition called preeclampsia. Preeclampsia is defined as maternal high blood pressure during pregnancy accompanied by signs of organ damage. Not only is preeclampsia a chief cause of preterm births, but this problem can eventually progress to eclampsia, which often results in seizures, coma, and even death.
Fortunately, recent studies have shown that aspirin therapy can help prevent the onset of preeclampsia in women with certain risk factors.
What Are the Risk Factors for Preeclampsia?
The threats of preeclampsia and eclampsia are one reason why OB-GYNs closely follow their patients’ blood pressures during prenatal visits. This monitoring is especially important for expectant mothers who are at an elevated risk for developing preeclampsia. The American College of Obstetricians and Gynecologists (ACOG) has delineated moderate and high-risk factors for preeclampsia.
Moderate-risk factors include:
- Maternal obesity with a body mass index (BMI) greater than 30
- Maternal age of 35 years or older
- First pregnancy
- Family history of preeclampsia
- Never have completed a pregnancy beyond 20 weeks
The following factors place a woman at high risk for preeclampsia:
- Previous preeclampsia
- Pregnancy with multiples (twins, triplets, etc.)
- Chronic high blood pressure
- Type 1 or 2 diabetes
- Autoimmune diseases
- Kidney disease
About Aspirin Therapy
Even if a patient has none of the above risk factors and has previously had a healthy, full-term pregnancy, daily aspirin therapy is still recommended for preeclampsia prevention. Aspirin is very low-cost, readily available, and has proven effective in reducing preeclampsia risk anywhere from 10-90%.
The standard dose of aspirin for adult use in the United States is 325 mg. However, this is the dose for analgesic or pain-relief effects. Aspirin therapy for stroke, heart attack, and preeclampsia prevention is usually dosed at 81 mg, a “baby” aspirin. This is the daily dose recommended for preeclampsia prevention.
Is Aspirin Dangerous?
Any drug can be dangerous if used improperly or without proper medical guidance. Even though aspirin is readily available over-the-counter at any drugstore or convenience store, this fact does not mean that aspirin use is risk-free. Aspirin acts as a blood thinner. While this property can be beneficial, it can also cause patients to bruise more easily and put them at a greater risk for internal bleeds. Furthermore, as with other NSAIDs, chronic aspirin use can irritate the stomach and contribute to gastric ulcers. However, “enteric-coated” aspirin, which is easier on the digestive system, is available.
The risks of low-dose aspirin use during pregnancy are extremely small for most women. In fact, an ACOG review found no increased risk of maternal hemorrhage or placental separation from the uterus associated with low-dose aspirin use. Also, low-dose aspirin has not been shown to cause fetal abnormalities.
Should You Begin Aspirin Therapy?
Let’s be very clear – pregnant women should never begin, discontinue, or change any drug without first consulting their OB-GYN. This rule applies to any vitamin, supplement, or medication, including over-the-counter medications like aspirin.
That said, you and your OB-GYN can decide together whether aspirin therapy is right for your situation. There are very few contraindications to aspirin therapy for preeclampsia prevention, and the risks to you and your baby are very low. The potential complications of preeclampsia are serious, so it makes sense to follow your OB-GYN’s advice and recommendations.
You can help with your treatment plan by making certain your OB-GYN, and all your healthcare providers, are fully informed of your complete health information. This means keeping them updated on your personal medical history as well as your family history, symptoms, medications, and allergies. You, the patient, are a vital part of your healthcare team.
About the Connecticut OBGYN Practice
Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowayton and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.
Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Women undergoing signs and symptoms of menopause can make an appointment with Laury for Hormone Replacement Therapy. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.