Aspirin Prophylaxis in High-Risk Pregnancies
Summary
Aspirin prophylaxis in high-risk pregnancies has emerged as a cornerstone intervention for reducing maternal and perinatal complications, notably preeclampsia and preterm birth. Low-dose aspirin, administered early in gestation, moderates the thromboxane–prostaglandin balance by irreversibly inhibiting cyclooxygenase enzymes, thereby improving placental perfusion and trophoblast invasion. Clinical protocols now recommend initiation before 16 weeks’ gestation in women with identifiable risk factors such as chronic hypertension, a history of preeclampsia or antiphospholipid syndrome, and abnormal uterine artery Doppler findings. Meta-analyses demonstrate a consistent reduction in the incidence of preeclampsia and suggest a modest impact on preterm birth rates. Beyond its antiplatelet effects, aspirin triggers the biosynthesis of anti-inflammatory lipoxins, which may further protect vascular endothelium. Adoption of this strategy has global significance: low cost, broad accessibility and a well-established safety profile underpin its appeal in both high- and low-resource settings. Ongoing research focuses on refining dose, timing and patient selection to maximise benefit and minimise residual risk.
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Aspirin Prophylaxis in High-Risk Pregnancies publication trend
The graph below shows the total number of articles in aspirin prophylaxis in high-risk pregnancies across all publications each year (not limited to Nature Index journals).
Technical terms
Low-dose aspirin (LDA): A daily regimen of 75–150 mg aspirin used to inhibit platelet aggregation and improve placental blood flow.
Preeclampsia: A pregnancy-specific hypertensive disorder after 20 weeks’ gestation, characterised by high blood pressure and organ dysfunction, often including proteinuria.
Prophylaxis: Preventive treatment administered to reduce the risk of a disease or complication.
Preterm birth: Delivery before 37 weeks’ gestation, associated with increased neonatal morbidity and mortality.
References
- Aspirin: The Mechanism of Action Revisited in the Context of Pregnancy Complications. Frontiers in Immunology (2017).
- Aspirin and Preeclampsia Prevention in Patients With Abnormal Uterine Artery Blood Flow. Iranian Red Crescent Medical Journal (2014).
- Aspirin for the prevention of preeclampsia: A systematic review and meta-analysis of randomized controlled studies. Frontiers in Cardiovascular Medicine (2022).
- Evaluation of low-dose aspirin in the prevention of recurrent spontaneous preterm labour (the APRIL study): A multicentre, randomised, double-blinded, placebo-controlled trial. PLOS Medicine (2022).
- Use of a Smartphone App to Explore Potential Underuse of Prophylactic Aspirin for Preeclampsia. JAMA Network Open (2021).
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