Do you need aspirin in pregnancy?
A question I’ll often see on Facebook groups is: “I’m hesitant to take aspirin in my pregnancy, does anyone have experience with this?”
Background of Gestational Hypertension and Preeclampsia
Aspirin in pregnancy is often recommended as a preventative strategy for preeclampsia. Preeclampsia is a hypertensive disorder of pregnancy, with most cases occurring in healthy women (who have never been pregnant) with no obvious risk factors.
Officially, it’s defined as gestational hypertension with new-onset proteinuria or one/more adverse conditions. Between 2012-2021, the prevalence of preeclampsia increased from 1.6% to 2.6% in Canada.
Signs & Symptoms of Preeclampsia
Signs and symptoms indicative of preeclampsia include:
Elevated blood pressure
Headaches
Abdominal pain
Shortness of breath or burning behind the sternum (chest bone)
Nausea and vomiting
Confusion
Heightened state of anxiety
Visual disturbances like oversensitivity to light, blurred vision, or seeing flashing spots or aura
What does aspirin do?
Aspirin has been shown to reduce the risk of preeclampsia in women at moderate or high risk of developing the condition (see below). Studies have shown that women who take aspirin are 53% less likely to develop preeclampsia compared to those who do not take it.
The American College of Obstetrics and Gynaecology recommends that women with any 1 of the high risk factors or 2 or more moderate risk factors should begin taking aspirin.
Starting aspirin should happen before 16 weeks of gestation for risk prevention to occur. Starting it after 16 weeks may not have the same impact.
Risk Factors for Preeclampsia
Preeclampsia is associated with a variety of future risks like hypertension, heart disease, and stroke. Identifying women at risk for preeclampsia is a great opportunity to address and prevent chronic illnesses.
Clinical risk factors fall into two categories - high and moderate. This matters because it would help care providers determine if a pregnant person should supplement with aspirin in pregnancy.
High Risk Factors - 1 needed for aspirin recommendation
History of preeclampsia
Multifetal gestation
Chronic hypertension
Diabetes mellitus I or II
Chronic kidney disease
Autoimmune disorder (ex. systemic lupus erythematosus, antiphospholipid syndrome)
Moderate Risk Factors - 2 needed for aspirin recommendation
No birth history
Obesity
Family history of preeclampsia
Socioeconomic factors
Age >35 years
Personal history factors (ex. low birth weight or small for gestational age, previous adverse pregnancy outcome, more than 10-year pregnancy interval)
Next Steps
There are additional ways to reduce preeclampsia risk in pregnancy. Consider booking an appointment with a Naturopathic Doctor to learn more.