Low-dose aspirin (LDA) prophylaxis is a safe and effective method to help prevent or delay preeclampsia in at-risk patients.
Low-dose aspirin (LDA) prophylaxis is a safe and effective method to help prevent or delay preeclampsia in at-risk patients. The cyclooxygenase inhibitor carries anti-inflammatory and anti-platelet properties that can support a patient’s health during pregnancy.
“Norton Women’s Care has recommended to all providers low-dose aspirin therapy for all pregnant women at risk for hypertensive disorders of pregnancy and/or preeclampsia to prevent this complication,” said Lyndsey D. Neese, M.D., MMM, FACOG, OB/GYN with Norton Women’s Care and medical director of quality for women’s services at Norton Healthcare.
Dr. Neese leads Norton Women’s Care’s initiative to supply low-dose aspirin during pregnancy to prevent or delay the onset of preeclampsia in our patients.
Recommendations: low-dose aspirin (LDA) in pregnancy
The American College of Obstetricians and Gynecologists (ACOG) recommends daily low-dose aspirin (81 milligrams per day) for all women at risk for pre-eclampsia. Prophylaxis should begin between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.
Refer a patient
To refer a patient to Norton Women’s Care, visit Norton EpicLink and choose EpicLink referral to Obstetrics/Gynecology.
High risk factors for preeclampsia include at least one of the following:
- History of preeclampsia, including:
- Early-onset preeclampsia and preterm delivery at less than 34 weeks
- More than one prior pregnancy complicated by preeclampsia
- Chronic hypertension
- Diabetes (Type 1 or Type 2)
- Renal disease
- Autoimmune disease
- Multifetal gestation
Moderate risk factors for preeclampsia include more than one of the following:
- First pregnancy
- Age 35 or older
- Body mass index (BMI) greater than 30
- Family history of preeclampsia
- Complications in a previous pregnancy
- Sociodemographic characteristics
- Black and/or lower-income patients are at greater risk.
Patients already receiving medically-indicated low-dose aspirin for other established conditions prior to 12 to 28 weeks can continue their low-dose aspirin treatment.
Administering LDA therapy earlier in pregnancy (prior to 11 weeks) does not decrease the risk of preeclampsia or other hypertensive disorders among high-risk women, according to a study.
Patients with a history of aspirin allergy, hypersensitivity to other salicylates/nonsteroidal anti-inflammatory drugs (NSAIDs), nasal polyps or asthma with aspirin-induced acute bronchospasm should not receive LDA therapy in pregnancy.
“Our baseline rate of LDA prescribing/documentation of the patient taking LDA in Epic in 2020 was 11%, and with education and reminders to providers, it has increased to 41% as of October 2022,” Dr. Neese said.