Low-dose aspirin may prevent preeclampsia: panel

By Andrew M. Seaman

NEW YORK (Reuters Health) - Pregnant women at a high risk for preeclampsia should take low-dose aspirin after the first trimester, according to a draft recommendation statement from the government-backed U.S. Preventive Services Task Force (USPSTF).

"Low-dose aspirin - in looking at benefit - reduced the risk of preeclampsia by 24%," Jillian Henderson, lead author of a review commissioned by the Task Force, told Reuters Health.

The therapy also reduced the risks of preterm delivery and intrauterine growth restriction.

The new USPSTF recommendations are available for public comment until May 5 here: http://bit.ly/ZKptK6.

Henderson, an epidemiologist at the Kaiser Permanente Center for Health Research Northwest in Portland, Oregon, is not a member of the USPSTF.

For the new review, she and her team searched several databases for past studies that examined the risks and benefits of low-dose aspirin in the prevention of preeclampsia.

"We found 23 studies that were considered good enough to include in the summary of this evidence," Henderson said.

They found that low-dose aspirin reduced the risk of preeclampsia by 24%, the risk of preterm birth by 14%, and the risk of intrauterine growth restriction by 20%.

About 4% of U.S. deliveries in 2010 were affected by preeclampsia, the authors note in their report, published April 7th online in the Annals of Internal Medicine.

Reducing preeclampsia rates by 24 percent means that about 3% of pregnancies would still be affected by the condition. But "because the outcomes are so serious, we care about a small reduction," Henderson said.

The researchers were not able to identify any harms associated with taking low-dose aspirin.

While there is no way to predict which women will go on to develop preeclampsia, the USPSTF refined the recommendation for women based on high and moderate risk factors.

Women with one high risk factor should take a low-dose (81 mg) aspirin every day after 12 weeks of pregnancy, the panel advises. The same goes for women who have multiple moderate risk factors.

High risk factors include prior preeclampsia, carrying twins or multiple babies, hypertension, diabetes and kidney or autoimmune diseases. Moderate risk factors include first time pregnancy, obesity, being older than 35 years and being African American or of low socioeconomic status.

"This certainly expands the therapy to a lot more women and will certainly expand our offering to more women," said Dr. Loralei Thornburg, a high-risk pregnancy expert at the University of Rochester Medical Center in New York. Thornburg was not involved in the new recommendation.

She said the American College of Obstetricians and Gynecologists currently recommends low-dose aspirin therapy only for women with a history of preeclampsia.

SOURCE: http://bit.ly/1qgpm91

Ann Intern Med 2014.

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