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It’s important to follow your doctor’s advice closely and understand why aspirin is being recommended in your case.
What is Aspirin and Why is It Used in Pregnancy?
Aspirin is a non-steroidal anti-inflammatory drug (NSAID) commonly used to relieve pain, reduce fever, or prevent blood clots. In pregnancy, low-dose aspirin is used for a specific reason: to help prevent or manage certain complications. It works by improving blood flow to the placenta and supporting healthy growth of the baby.Low-dose aspirin is primarily used to reduce the risk of preeclampsia, a serious condition involving high blood pressure that can affect you and your baby. It has antiplatelet properties, meaning it stops blood cells from clumping together and forming clots. This improves blood flow to the uterus and placenta. It may also lower the chances of preterm birth (before 37 weeks), having a baby smaller than expected, or experiencing stillbirth.
What is Preeclampsia?
Preeclampsia is a condition that can develop in pregnancy, during labour, or shortly after delivery. It’s marked by high blood pressure and can affect organs like your kidneys, liver, eyes, or brain. If left untreated, it may pose serious problems for you and your baby.- Symptoms: Headaches, vision changes (like seeing spots or blurriness), upper stomach pain, nausea, vomiting, difficulty breathing, or swelling in your hands, face, or legs.
- Impact on baby: Preeclampsia can cause poor growth in the womb, leading to intrauterine growth restriction (IUGR) or a small-for-gestational-age (SGA) baby.
- Prevalence: According to the World Health Organization (WHO), it affects about 2 to 8 per cent of pregnancies globally.
- Treatment: The only treatment option is to deliver the baby. But if it’s too early, your doctor may monitor you closely, prescribe medications to lower blood pressure, or use magnesium supplements until delivery is safe.
Who Should Take Low-Dose Aspirin During Pregnancy?
Not every pregnant person needs to take aspirin. Your doctor will recommend it if you’re at high or moderate risk for preeclampsia or other complications. They’ll assess your medical history and risk factors to decide if it’s right for you.High-Risk Factors
- History of preeclampsia in a previous pregnancy.
- Chronic high blood pressure (hypertension) before or during pregnancy.
- Type 1 or Type 2 diabetes.
- Chronic kidney disease.
- Autoimmune diseases like lupus or antiphospholipid syndrome.
- Multiple pregnancy (twins, triplets, or more).
- Low Pregnancy Associated Plasma Protein (PAPP-A) from screening tests.
- Previous preterm birth before 34 weeks.
- A history of a baby born smaller than expected.
- Two vessels in the baby’s umbilical cord (instead of the usual three).
Moderate-Risk Factors
Aspirin may be recommended if two or more apply:- First pregnancy.
- More than 10 years since your last pregnancy.
- Body Mass Index (BMI) of 35 or higher.
- Family history of preeclampsia (if your mother or sister had it).
- Age 35 or older.
- BMI less than 18.5 with additional factors like a bowel disorder.
- History of gastric bypass surgery.
- Tobacco smoking.
- Pregnancy through in vitro fertilisation (IVF).
- A low birthweight baby in a previous pregnancy.
Other Considerations
- Social stressors like low income or limited access to healthcare can increase preeclampsia risk.
- Concerns about placental function in a previous pregnancy may also lead to a recommendation for aspirin.
How and When to Take Low-Dose Aspirin
If your healthcare professional recommends low-dose aspirin, they’ll give you specific instructions on how to take it. Following their guidance is important to make sure it’s effective and safe. Your doctor will prescribe the right dosage for you. You may start taking it between 12 and 28 weeks of pregnancy, ideally before 16 weeks for maximum benefit. Continue use until 36 weeks or delivery, unless your doctor advises otherwise.It's safe to take it in the evening with or after food to reduce the chance of stomach upset. If you miss a dose, reach out to your doctor. They may suggest taking it as soon as you remember, but not going over the recommended dose in a day. You can stop taking aspirin if you feel like labour has started, and wait until it’s confirmed.
Is Low-Dose Aspirin Safe During Pregnancy?
Low-dose aspirin is generally considered safe for most pregnant people when recommended by a healthcare professional. There is no evidence that low-dose aspirin causes any harm to the baby during pregnancy or after birth.Some of the side effects of aspirin in pregnancy include:
- Mild indigestion is possible. Taking aspirin with food or after a meal can help.
- Wait at least two hours before or after taking aspirin if you take indigestion remedies.
- People allergic to aspirin or other NSAIDs (like ibuprofen or naproxen).
- Those with hypersensitivity to salicylates or nasal polyps.
- Individuals with severe asthma, lung disease, liver problems, or chronic kidney issues (unless advised by a doctor).
- People with stomach ulcers, Crohn’s disease, ulcerative colitis, gout, or a history of gastrointestinal bleeding.
- Those with blood clotting disorders or previously advised against taking aspirin.
Risks of Higher-Dose Aspirin During Pregnancy
Low-dose aspirin is considered safe by doctors, but higher doses during pregnancy are not recommended due to potential risks.- Higher doses in the first trimester may increase the risk of pregnancy loss.
- There’s a small chance of congenital defects (medical conditions present at birth).
- Risk of rare but serious kidney problems in the baby.
- Higher doses may cause a blood vessel in the baby’s heart to close too soon, affecting foetal health.
- Increases the risk of brain bleeding in premature babies.
Low-dose aspirin can be a safe and effective way to reduce the risk of preeclampsia and related complications for those at higher risk. Always talk to your doctor before starting aspirin to make sure it’s suitable for you. They can guide you on the right dosage, timing, and help you manage any side effects.
FAQs on Aspirin Use During Pregnancy: Is It Safe?
- Is aspirin safe to take during pregnancy?
Low-dose aspirin is considered safe for most people when prescribed by a healthcare professional. It should only be taken under medical advice. - Who needs to take low-dose aspirin while pregnant?
It’s recommended for people at high or moderate risk of preeclampsia or other complications. Your doctor will assess your risk before suggesting it. - Who should not take aspirin in pregnancy?
Aspirin may not be safe for people who have allergies to NSAIDs, a history of ulcers, asthma, kidney or liver problems, or certain bleeding conditions.