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Aspirin reduces pregnancy complications

Aspirin treatment during pregnancy can reduce the risk of pre-eclampsia, premature birth and serious complications of pregnancy.

Aspirin reduces pregnancy complications

Aspirin treatment during pregnancy can reduce the risk of pre-eclampsia, premature birth and serious complications of pregnancy. Pre-eclampsia is a condition of pregnancy that affects multiple systems of the body and is characterised by high blood pressure and protein in the urine. It can affect the blood vessels that supply the placenta causing irregular blood flow and the formation of clots. The condition occurs in 2-8% of pregnancies and accounts for up to 15 percent of the 500,000 pregnancy-related deaths worldwide each year. Australian researchers from the University of Sydney analysed 31 clinical trials that included 32,217 women and their 32,819 babies. Most of the women (98 percent) received aspirin. Other anti-platelet drugs included heparin and dipyridamole. Platelets are cell fragments in blood that help the blood to clot to avoid excessive bleeding. Anti-platelet drugs reduce platelet stickiness and accumulation, lowering the risk of blood clots and subsequent heart attack or stroke - which are more likely to occur when blood pressure is very high. Aspirin, along with other drugs with anti-platelet effects, are associated with reduced risk of pre-eclampsia, birth before 34 weeks of gestation, and a serious adverse outcome of pregnancy. It was found that women treated with antiplatelet agents had a 10-percent less chance of pre-eclampsia, delivering before 34 weeks, and having a pregnancy with a serious adverse outcome. In contrast, antiplatelet agents did not reduce the risks of fetal death, small infants, or episodes of bleeding. The findings suggest that more frequent use of aspirin or other antiplatelet agent during pregnancy may be worthwhile from a public health standpoint, particularly in women with a high risk for pre-eclampsia. There are certain cases in which pre-eclampsia is almost a certainty, including women who have already had pre-eclampsia in more than one pregnancy or women with chronic high blood pressure and pre-eclampsia, and for these women, aspirin is justified. More studies are needed to find out whether benefits outweigh any long-term risks under other circumstances like chronic high blood pressure, several previous pregnancies, or pre-existing diabetes.
The Lancet,
May 2007
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