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Aspirin reduces the risk of preeclampsia

Wednesday 5 Oct 2022
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Preeclampsia affects 5-8% of all pregnant women annually and is a hypertensive condition that globally is one of the main causes of maternal mortality and morbidity in mothers and fetuses.1

A large number of research studies have shown that one 75 mg tablet of aspirin per day significantly reduces the risk of preeclampsia.2 In some countries, among them Sweden, healthcare authorities therefore have introduced routines for preventive treatment with aspirin. Women belonging to the risk group are recommended to prophylactically take 75 mg of acetylsalicylic acid from week 10-12, until week 36.3

Preeclampsia is a complex condition and researchers have not yet fully understood its underlying causes.1 The disease is characterized by the placenta not properly attaching to the uterine wall, causing substances that normally only are present in the fetus to enter the mother’s blood stream. The nutrient supply to the fetus also deteriorates.1 The mother’s immune system gets triggered by the unknown substances, giving an inflammatory response that damages the blood vessels and causes them to contract.4,5 This in turn causes proteins to leak into the urine and the blood pressure to rise.4

Preeclampsia can appear from pregnancy week 20, but usually shows as late as after week 34. The symptoms vary greatly, which makes the condition difficult to diagnose, but typical symptoms are headache, visual problems, swelling or acute pain in the upper abdomen, especially under the ribs on the right hand side.6 Anyone who experiences symptoms such as these during the latter part of pregnancy should contact healthcare.

At present, there is no other available treatment than to deliver the child prematurely.3 However, blood pressure-lowering medication, reduced stress and monitoring in hospital are measures that can be put in place to postpone a possible premature birth.4 Normally, the symptoms disappear shortly after the baby is born.

 

Examples of high risk factors Examples of medium risk factors
  • Suffered from preeclampsia previously
  • Chronic kidney disease
  • Egg donation
  • Diabetes mellitus before the pregnancy
  • Multiple births (i.e twins or more)
  • Chronic hypertension
  • Carrying her first child or more than 10 years since last pregnancy
  • BMI > 30
  • Age > 40
  • Heredity
  • Hypertension early in pregnancy

Pregnant women with one high risk factor or three or more medium risk factors are considered to belong to the risk group that can benefit from taking Aspirin. Important! Never start any medication on your own, please consult your doctor before starting any medication.

References  
1.

Pre-eclampsia: its pathogenesis and pathophysiology, Cardiovasc J Afr. 2016. Volume 27 (71–78) P Gathiram and J Moodley

2.

Aspirin Prophylaxis During Pregnancy: A Systematic Review and Meta-Analysis, Am J Prev Med. 2021 Volume 61 (e31-e45). Yeo Jin Choi, Sooyoung Shin

3.

Preeklampsi. Stockholm: Svensk förening för obstetrik och gynekologi (SFOG), Arbets- och referensgrupp för perinatologi; 2013. Rapport nr 72 (Swedish)

4.

Havandeskapsförgiftning. 1177 Region Uppsala [Web-page]. 2020. (Swedish)

5.

Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Phipps, Nat Rev Nephrol  2019, 15275–289. E.A., Thadhani, R., Benzing, T. et al.

6.

The photo was taken by Engin Akyurt and downloaded from Unsplash.