Low-Dose Aspirin May Help People With History of Pregnancy Loss

A new study from the American College of Physicians found that taking low-dose aspirin on a daily basis may improve pregnancy outcomes for people who previously experienced pregnancy loss.

The report, published in the Annals of Internal Medicine on Monday, Jan. 25, found that the benefits were more pronounced in people who started taking aspirin daily prior to conception.

The pregnancy outcomes were also greater when people strictly adhered to low-dose aspirin therapy, taking it between 4 and 7 days a week.

The researchers suggest more focus is needed on educating people on the importance of adhering to aspirin therapy to achieve the beneficial effects on their pregnancies.

“There is growing consensus that low-dose aspirin may be helpful for those at risk. It should be started well before pregnancy and used consistently to have maximal effect,” Dr. Hugh Taylor, the department chair of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, told Healthline.

Aspirin isn’t recommended for everyone due to the risk of bleeding, so it’s important to talk with a doctor about the benefits and risks of low-dose aspirin therapy before trying this method.

Low-dose aspirin can improve pregnancy outcomes in at-risk people

Researchers from Emory University and the National Institutes of Health evaluated the health data from the effects of aspirin in gestation and reproduction (EAGeR) trial, which included 1,227 people who were trying to become pregnant and previously experienced one or two pregnancy losses.

The EAGeR trial previously concluded that taking low-dose aspiring daily didn’t improve pregnancy outcomes. But the researchers conducted a post hoc analysis to factor in how strictly the people included in the study adhered to the aspirin therapy.

The researchers found that strictly adhering to a low-dose aspirin regimen at least 4 days a week led to eight more pregnancies, six fewer pregnancy losses, and 15 more live births for every 100 people in the trial.

This is a 30 percent increase in live births.

The findings show how helping people stick with the aspirin therapy could ultimately improve the medication’s effect on pregnancy outcomes, according to the researchers.

Why does aspirin have this effect?

Aspirin is routinely recommended to pregnant people with preeclampsia (high blood pressure during pregnancy) and antiphospholipid syndrome (an autoimmune disorder that causes blood clots).

Taylor said preeclampsia can impact the growth of babies and be fatal to the mother.

Antiphospholipid syndrome can lead to pregnancy loss, and can predispose someone to preeclampsia, Taylor noted.

According to Dr. Jennifer Wu, an OB-GYN at Lenox Hill Hospital in New York City, aspirin improves blood flow across the placenta, which helps lead to fewer miscarriages.

“Because preeclampsia is a disorder of the placental blood flow and antiphospholipid syndrome is a clotting disorder, a blood thinner such as aspirin can also help with these conditions,” Wu said.

Should you take aspirin?

Taylor recommends that people with previous pregnancy loss talk with their doctor if they’re interested in the effects of aspirin.

Aspirin can increase the risk of bleeding, so people prone to bleeding — such as those with ulcers — should avoid aspirin therapy, Taylor said.

“Aspirin may be beneficial for everyone thinking of having a baby, but until we know that to be true, I would recommend it for women who have had a prior loss or who have risk factors such as an underlying autoimmune or inflammatory condition or who are at risk for high blood pressure,” Taylor said.

Those with an allergy to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) should also avoid taking it.

For people who may benefit from aspirin, it’s best to start with a low-dose regimen well before one tries to conceive.

“Specifically these patients need to start early in pregnancy or even before they achieve pregnancy and there is a real importance to taking the aspirin daily,” Wu said.

In more severe cases, other anticoagulation medications may be recommended.

Aspirin can’t prevent all types of pregnancy loss. Many miscarriages are due to genetic causes, Taylor said.

“Maintaining good health prior to and during pregnancy will have an even more profound effect than aspirin or any medical therapy for most women,” Taylor said.

The bottom line

New research found that taking low-dose aspirin on a daily basis may improve pregnancy outcomes for people who previously experienced pregnancy loss.

Aspirin improves blood flow to the placenta, so it can help with preeclampsia and antiphospholipid syndrome — two conditions that can impact the health of a pregnancy.

Before taking low-dose aspirin, talk with a doctor who can weigh your personal benefits and risks.

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Source: Healthline