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Aspirin 'can help at-risk mothers' during pregnancy

Taking low doses of aspirin in early pregnancy and calcium supplements in the latter stages can help prevent the onset of pre-eclampsia in mothers at risk of the condition, research has found.

Women in “low-intake populations” can reduce the chances of pre-eclampsia developing by taking low doses of aspirin before 16 weeks, and also calcium supplements after 20 weeks, the report published in The Obstetrician & Gynaecologist found.

It is also possible to assess a woman’s risk of developing pre-eclampsia from as early as 11 weeks of pregnancy, say the authors.

Pre-eclampsia affects around 3% to 5% of pregnancies and accounts for more than 50,000 maternal deaths worldwide every year.

It is characterised by a combination of raised blood pressure and protein in the urine, and can lead to complications including stroke and eclampsia - life-threatening seizures - as well as multiple-organ failure, foetal growth restriction, intrauterine death and pre-term labour.

The research examined pre-eclampsia in the first and second trimester and prevention using low-dose aspirin and calcium supplementation.

Taking low levels of aspirin before 16 weeks was found to have a significant effect in the prevention of pre-eclampsia, as was taking calcium supplements in women that are calcium-deficient.

Assessing women at 11 weeks to ascertain whether they were at risk of developing the condition was done through blood-pressure monitoring, using biochemical marker levels and uterine artery Doppler assessment.

To best assess the risks, the authors found that a combination of investigations were required, including examining maternal history and using biophysical and biochemical marker screening.

While treatment is currently reserved for at-risk pregnancies, in the future management could be tailored around preventative treatment based on the results of first trimester screening, the report authors said. But more research would be needed to see if these therapies could be beneficial in low-risk populations.

Fionnuala Mone, clinical fellow at University College Dublin’s school of medicine and medical science, who co-authored the review, said: “Use of low-dose aspirin and calcium supplementation in at-risk populations can reduce the risk of developing pre-eclampsia, a serious condition which can lead to complications for both the mother and her baby.

“It is important to see if low-risk women can benefit from preventative treatments and screening through future research.”

Jason Waugh, editor-in-chief of The Obstetrician & Gynaecologist

Jason Waugh, editor-in-chief of The Obstetrician & Gynaecologist, said: “First trimester testing is a potential tool for clinicians to screen and then subsequently offer prophylaxis to prevent pre-eclampsia.

“However, not all units will have access to sonographers trained in uterine artery Doppler or laboratories able to analyse biochemical marker levels and this needs to be taken into account if first trimester screening is extended to low-risk pregnancies.”

 

 

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