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 The draft recommendation from the U.S. Preventive
Services Task Force (USPSTF) is based on a review of the evidence
that found low-dose aspirin reduced the likelihood of developing the
condition and its complications.
"Low-dose aspirin — in looking at benefit — reduced the risk of
pre-eclampsia by 24 percent," Jillian Henderson, the review's lead
author, told Reuters Health.
The therapy also reduces the risks of having to deliver the baby
early and of the baby growing too slowly in the womb, she said.
Henderson is a researcher at the Kaiser Permanente Center for Health
Research Northwest in Portland, Oregon. She is not a member of the
USPSTF.
pre-eclampsia is a condition that occurs in 2 to 8 percent of
pregnancies. It's defined by the onset of high blood pressure and
high urine protein levels during pregnancy, according to the USPSTF.
The condition is one of the leading causes of maternal death
worldwide. It's also responsible for 15 percent of preterm births in
the U.S.
For the new review, the researchers searched several databases for
past studies that examined the risks and benefits of low-dose
aspirin in the prevention of pre-eclampsia. "We found 23 studies that were considered good enough to include in
the summary of this evidence," Henderson said.
They found that taking a low-dose aspirin reduced the risk of
pre-eclampsia by 24 percent. It also reduced the risk of preterm
birth by 14 percent and the risk that the baby would grow too slowly
in the womb by 20 percent.
About 4 percent of U.S. deliveries in 2010 were affected by
pre-eclampsia, the authors note in their report, published in the
Annals of Internal Medicine.
It's hard to know what a 24 percent reduction would mean to that
number, because the reduction would be in high-risk women and we
don't know how many of them there are, Henderson said.
But even in an ideal world it's likely that at least 3 percent of
pregnancies would still be affected by the condition.
"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
pre-eclampsia, the USPSTF refined the recommendation for women based
on high and moderate risk factors.
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Women with one high risk factor should take a
low-dose (81 milligram) 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 pre-eclampsia, having twins or multiple babies, high
blood pressure, diabetes and having 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," Dr. Loralei Thornburg
said.
Thornburg was not involved in making the new recommendation. She is
a high-risk pregnancy expert at the University of Rochester Medical
Center in New York. She said the American College of
Obstetricians and Gynecologists currently recommends low-dose
aspirin therapy, but only for women who have a history of
pre-eclampsia.
Henderson cautioned that women shouldn't start taking low-dose
aspirin without talking to their doctors first.
"It shouldn't be something done with a broad brush that people are
considering for themselves," she said.
The new USPSTF recommendations are available for public comment
until May 5 here:
http://bit.ly/ZKptK6. ___
Spirce: http://bit.ly/1qgpm91
Annals of Internal Medicine, online April 7, 2014.
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