Aspirin in Pregnancy

• Indication: Preeclampsia
• Dose: 75mg/day

Product Leaflet :

• Aspirin should not be used in pregnancy as it may be associated with prolongation of labour and with maternal and neonatal bleeding.

Lexicomp :

• Salicylates do cross placenta.
• Use of aspirin close to delivery may cause premature closure of the ductus arteriosus.
• Low dose may be used to prevent preeclampsia in women with history of early-onset preeclampsia and preterm delivery, or preeclampsia in more than 1 prior pregnancy.
• Low dose aspirin is used to treat complications resulting from antiphospholipid syndrome in pregnancy (either primary or secondary to SLE)
• Low dose aspirin to prevent thrombosis may also be used during the second and third trimesters in women with prosthetic valves (mechanical or bio prosthetic).
• The use of warfarin is recommended, along with low dose aspirin, in those with mechanical valves.

• In general, low doses during pregnancy needed for the treatment of certain medical conditions have not been shown to cause fetal harm: however, discontinuing therapy prior to delivery is recommended.

Drugs.com:

• Aspirin has not been formally assigned to pregnancy category by the FDA. However, aspirin is considered to be in pregnancy category D by the FDA if full dose aspirin is taken in the third trimester.
• High doses have been associated with increased perinatal mortality, intrauterine growth retardation, and teratogenic effects.
• FDA issued a warning that it is especially important not to use aspirin during the last trimester of pregnancy unless specifically directed to do so by a physician because it may cause problems in the unborn child or complications during delivery.
• Increased maternal bleeding can occur during delivery when aspirin is used 1 week prior to and/or during labor and delivery. Prolonged gestation and labor have been reported due to aspirin's inhibition of prostaglandin.
• Low dose aspirin in pregnancy is safe with respect to the risks of malformation and of major impairment in development at 18 months of age

US Preventive Services:

• Pregnant Women Who Are At High Risk for Preeclampsia: The USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia.

WHO Guidelines

Antiplatelets for Prevention of Pre-eclampsia:

• Low-dose acetylsalicylic acid (aspirin, 75 mg/day) is recommended for the prevention of pre-eclampsia in women at high risk of developing the condition. (Moderate-quality evidence, Strong recommendation)
• Low-dose acetylsalicylic acid (aspirin, 75 mg/day) for the prevention of pre-eclampsia and its related complications should be initiated before 20 weeks of pregnancy. (Low-quality evidence, Weak recommendation)