Pregnancy is a time of excitement, anticipation, and, for many, a fair share of questions about what’s safe and what’s not. Many moms who are expecting for the first time ask whether it’s safe to take aspirin during pregnancy. The answer isn’t straightforward and depends on your specific health circumstances and doctor’s guidance.
With that said, there are certain times when low-dose or “baby aspirin” is recommended by doctors, especially when there is an increased risk of preeclampsia.
Let’s explore the role of low-dose aspirin during pregnancy and learn how it can be a key tool in managing specific conditions that pose a risk to mother and unborn child.
What Is Baby Aspirin, and Why Is It Used During Pregnancy?
Baby aspirin is a low-dose aspirin, typically containing 81 milligrams (mg) of the active ingredient, acetylsalicylic acid. Unlike regular aspirin, often used for pain relief or to reduce inflammation, baby aspirin is primarily used for its blood-thinning properties.
During pregnancy, it’s sometimes prescribed to help prevent certain complications, such as preeclampsia, a serious condition characterized by high blood pressure and organ damage.
According to the American College of Obstetricians and Gynecologists (ACOG), low-dose aspirin is recommended for pregnant individuals at high risk of preeclampsia. This recommendation is based on extensive research showing that baby aspirin can reduce the risk of developing this condition and its associated complications.
Who Might Benefit From Baby Aspirin During Pregnancy?
Not every pregnant person needs to take baby aspirin. It’s typically recommended for those with the specific risk factors listed above, and a few other circumstances listed below.
The Most Common Conditions When Aspirin May Be Used During Pregnancy
- A history of preeclampsia in a previous pregnancy: Moms who have experienced preeclampsia before are at a higher risk of developing it again. Research shows that low-dose aspirin can reduce this risk by improving blood flow to the placenta and reducing inflammation. Studies cited by the National Center for Biotechnology Information (NCBI) support its use in this group.
- Chronic high blood pressure or kidney disease can impair blood flow and increase the risk of preeclampsia. Baby aspirin helps by promoting better circulation and reducing the likelihood of blood clots.
- Autoimmune disorders like lupus: Lupus and similar conditions can cause inflammation and blood vessel damage, increasing the risk of pregnancy complications. Baby aspirin’s anti-inflammatory properties can help mitigate these risks.
- Diabetes (type 1 or 2): Diabetes can damage blood vessels and cause poor placental function. Low-dose aspirin, as noted in clinical guidelines from the American College of Obstetricians and Gynecologists, may improve blood flow and reduce the risk of complications like preeclampsia.
- Carrying multiples (e.g., twins or triplets): Multiple pregnancies put extra strain on the body and increase the risk of preeclampsia. Baby aspirin can help manage this risk by improving placental blood flow.
While we have focused a lot on preeclampsia, there are two less common conditions in which baby aspirin is sometimes used to keep mother and baby safe.
Aspirin Use in IVF: A Topic Of Ongoing Debate
The rationale behind aspirin use in IVF cycles is to enhance uterine blood flow and improve endometrial receptivity, potentially increasing the chances of embryo implantation.
However, the evidence supporting this practice is inconclusive. Some studies suggest a potential benefit, while others do not demonstrate a significant improvement in pregnancy rates. Therefore, the routine use of aspirin in IVF treatments remains a topic of debate among clinicians.
While not conclusive, I provided this information so you can talk to your IVF provider about the benefits and potential risks associated with taking low-dose aspirin at this stage in your pregnancy planning.
Aspirin for Recurrent Pregnancy Loss and APS
APS is an autoimmune disorder characterized by the presence of antiphospholipid antibodies, which increase the risk of blood clots and are associated with recurrent miscarriages.
For women with APS, a combination therapy of low-dose aspirin and heparin has been shown to improve pregnancy outcomes.
A meta-analysis published in the Journal of Thrombosis and Haemostasis concluded that heparin plus aspirin may enhance live birth rates in women with recurrent pregnancy loss and antiphospholipid antibodies, although the evidence is of low certainty.
It’s essential for women considering aspirin therapy in these contexts to consult with their healthcare providers. The decision to use aspirin should be individualized, taking into account personal medical history, underlying conditions, and the potential benefits and risks of the therapy.
The Mayo Clinic emphasizes that baby aspirin should only be taken under medical supervision for any of the above situations. Your healthcare provider will evaluate your risk factors and determine whether the benefits outweigh the potential risks.
How Does Baby Aspirin Help Prevent Preeclampsia?
Preeclampsia is a leading cause of maternal and fetal complications, including preterm birth, low birth weight, and even life-threatening conditions like eclampsia.
Research suggests that preeclampsia may be linked to problems with blood flow to the placenta. Baby aspirin improves blood flow and reduces inflammation, which can help lower the risk of developing this condition.
A study published by the National Institutes of Health (NCBI) highlights that low-dose aspirin can significantly reduce the incidence of preeclampsia in high-risk individuals when started early in pregnancy, typically before 16 weeks.
When Should Expecting Moms Start Taking Baby Aspirin, And When Should They Stop?
Timing is crucial when it comes to taking baby aspirin during pregnancy. According to What to Expect, most healthcare providers recommend starting low-dose aspirin between weeks 12 and 16 of pregnancy. Starting too late may reduce its effectiveness in preventing preeclampsia and other conditions.
At the same time, many doctors urge expecting mothers to stop their use of aspirin around 36 weeks to reduce bleeding risk during delivery. This is, again, a discussion you will want to have with your healthcare provider.
Is Baby Aspirin Safe During Pregnancy?
Safety is a top concern for any medication taken during pregnancy. Benadryl during pregnancy comes up a lot, and it’s also a standard over-the-counter drug. Like Benadryl, baby aspirin is an OTC option, and its use also comes down to a mother’s unique situation.
While baby aspirin is generally considered safe for most pregnant individuals, it’s not without potential risks. For example, taking higher doses of aspirin during pregnancy can increase the risk of bleeding complications for both the mother and the baby.
There are two less common situations that have been highlighted by researchers:
Placental Abruption: This serious condition involves the premature detachment of the placenta from the uterine wall. Some studies have explored the relationship between aspirin use and placental abruption:
- A meta-analysis published in the American Journal of Obstetrics and Gynecology examined the effect of aspirin on the risk of placental abruption. The study found that aspirin at a daily dose of ≥100 mg, initiated at ≤16 weeks of gestation, may decrease the risk of placental abruption or antepartum hemorrhage.
- Conversely, a study in Ultrasound in Obstetrics & Gynecology reported that low-dose aspirin was associated with an increased risk of placental abruption. The adjusted odds ratio was 1.44, translating to a number needed to harm of 287.
Fetal Risks: Higher doses of aspirin or prolonged use, especially in the third trimester, have been associated with fetal complications:
- Premature Closure of the Ductus Arteriosus: The ductus arteriosus is a vital fetal blood vessel that typically closes after birth. NSAIDs, including higher doses of aspirin, may cause this vessel to close prematurely, leading to fetal circulation issues. This risk is particularly noted with NSAID use after 28 weeks of gestation.
The University Hospitals Blog notes that low-dose aspirin is unlikely to cause harm when used as directed. However, it is essential to follow your doctor’s instructions carefully and avoid self-medicating.
What Are the Potential Side Effects Of Taking Aspiring While Pregnant?
While baby aspirin is well-tolerated by most people, some may experience mild side effects. Because of the delicate nature of pregnancy, you should consult with your doctor immediately if you notice any of the following issues.
- Upset stomach: Aspirin can irritate the stomach lining, leading to discomfort or heartburn. This happens because aspirin reduces the production of substances that protect the stomach lining.
- Heartburn: The same irritation that causes an upset stomach can also lead to acid reflux or heartburn.
- Nausea: Some individuals may feel nauseous due to how aspirin interacts with the digestive system.
In rare cases, it can lead to more serious complications, such as gastrointestinal bleeding or allergic reactions. I can’t stress enough that you should always report any unusual symptoms to your healthcare provider.
Alternative Preventive Measures For Preeclampsia
Since baby aspirin is primarily recommended to reduce preeclampsia risk, other steps can be taken by expecting moms to help reduce that risk.
Making lifestyle and dietary changes can go a long way. These include increasing your calcium intake, maintaining a safe weight, and avoiding excessive salt. Working with your doctor or a dietician who specializes in pregnancy can help you make the changes you need at the start of your pregnancy and even during the pregnancy planning stages.
As your pregnancy progresses, it’s also crucial that you receive proper prenatal monitoring and testing. We’ve written an article on the routine tests performed during pregnancy which highlights the testing milestones for each week of pregnancy.
Also, be sure to manage stress when needed and stay properly hydrated to avoid further complications.
The Bottom Line: Should You Take Baby Aspirin During Pregnancy?
The decision to take baby aspirin during pregnancy should always be made in consultation with your healthcare provider. For those at high risk of preeclampsia or other pregnancy-related complications, low-dose aspirin can be a lifesaving intervention.
Baby aspirin use while pregnant is not a one-size-fits-all solution, and its use must be carefully tailored to your individual health needs. There are some situations in which aspirin could do more harm than good, for example, in women with bleeding disorders (e.g., hemophilia), an aspirin allergy or sensitivity (e.g., asthma triggered by NSAIDs) or a history of stomach ulcers or gastrointestinal bleeding.
Talk to your doctor to determine if baby aspirin is right for you. They can help you weigh the risks and benefits and ensure you and your baby stay healthy throughout your pregnancy.
As always, the information contained in this article should not replace a direct discussion with your healthcare provider. Your personal medical history and current situation needs to be carefully examined before any decisions are made about your use of aspirin during pregnancy.