The US Preventive Services Task Force (USPSTF) drafted a proposed recommendation that certain pregnant women be routinely prescribed a regimen of one 81-milligram of aspirin — a baby aspirin — beginning at the 12th week of pregnancy. The USPSTF has publicly published the draft recommendation so anyone wishing to comment on it can do so. Your comments are welcome through May 5, 2014.
The aspirin is expected to reduce the risk of preeclampsia, a medical condition that can jeopardize pregnancy and be fatal to mothers. The recommendation is for women considered at high risk for developing the condition. To be considered high risk for preeclampsia, a woman:
- Has had preeclampsia in the past
- Is diabetic
- Has high blood pressure
- Is obese
- Has an immune disorder
- Is pregnant with multiples
One of the most concerning aspects of preeclampsia is that it is impossible to predict. Until symptoms appear, usually in the latter half of the pregnancy, any woman is at risk, even those who don't fall into the traditionally recognized high-risk pregnancy group.
Symptoms of preeclampsia include high blood pressure and sudden appearance of protein in the urine. Preeclampsia is the cause of death in 12% of all maternal fatalities and 15% of all preterm deliveries. Jillian T. Henderson describes preeclampsia as "one of the leading causes of maternal mortality" and "although they're very rare, some of the outcomes are quite catastrophic." Henderson is a Kaiser Permanente Center for Health Research associate.
About 152,000 cases occur each year, affecting about 3.8% of all pregnancies in the US in a given year. That percentage, however, is rising at an alarming rate. Between 1980 and 2010, the number of preeclampsia diagnoses in the US grew by more than 300%.
Researchers working with the USPSTF, including Henderson, reviewed the findings of 23 medical studies published from 1986 through 2014. They discovered women at high risk who took a single baby aspirin a day during the last half of pregnancy were:
- 14% less likely to deliver preterm
- 20% less likely to have a baby with intrauterine growth restriction (IUGR)
Intrauterine growth restriction is diagnosed when a developing fetus grows slower than normal.
Eleni Tsigas welcomes the recommendation. The executive director of the Preeclampsia Foundation lost one child to preeclampsia in 1998 and suffered severely with it during her second pregnancy. "We support women talking to their caregivers about low-dose aspirin," she says, and sees two messages coming from the draft proposal:
- "Women really do need to control the things they can control to have a healthy pregnancy."
- "Even if you are healthy, you are not off the hook. All women are at risk."
Tsigas says the condition is tricky because it is unpredictable.
Source: "Low-dose Aspirin for Preeclampsia." Commenting on Task Force Draft Recommendations. US Preventive Services Task Force. Apr 8, 2014. Web. Apr 16, 2014.