ACOG Guideline for use of low-dose Aspirin during pregnancy

The American College of Obstetricians and Gynecologists have issued new recommendations for the use of low-dose aspirin in pregnancy. Aspirin is a cyclooxygenase inhibitor with anti-inflammatory and antiplatelet properties. Low-dose aspirin has been used during pregnancy most commonly to prevent or delay the onset of preeclampsia.

In November 2013, ACOG issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia.

The following year, the U.S. Preventive Services Task Force (USPSTF) published a similar guideline, although the list of indications for low-dose aspirin use was more expansive. The USPSTF guideline also suggested that low-dose aspirin is considered in women with “several” moderate risk factors for preeclampsia.

The recommendations are published in the journal Obstetrics & Gynecology.

Key Recommendations:

• Low-dose aspirin prophylaxis is not recommended for the prevention of early pregnancy loss.


• Low-dose aspirin prophylaxis is not recommended for the prevention of spontaneous preterm birth, in the absence of risk factors for preeclampsia.


• Low-dose aspirin prophylaxis is not recommended for the prevention of fetal growth restriction, in the absence of risk factors for preeclampsia.


• Low-dose aspirin prophylaxis is not recommended solely for the indication of prior unexplained stillbirth, in the absence of risk factors for preeclampsia.


• Low-dose aspirin prophylaxis should be considered for women with more than one of several moderate risk factors for preeclampsia.


• Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.

Daily low-dose aspirin use in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use.

For further information follow the link: 10.1097/AOG.0000000000002708