Low dose aspirin can cut risk of preeclampsia in pregnant women

Giving pregnant women a low dose of aspirin daily after 12 weeks of pregnancy reduces the risk of developing preeclampsia, according to research published in the New England Journal of Medicine.
In a study, women who had been identified as being at high risk for preterm preeclampsia, during screening in the first trimester, were given a dose of 150 mg of aspirin every day, starting from 11 to 14 weeks of gestation, until 36 weeks of gestation.

STUDY RESULTS

Of the 26,941 pregnant women involved in the study, 2,971 were identified as being at risk of developing preterm preeclampsia.
One group of women was given aspirin while another group was given a placebo. Eighty per cent of the participants took the recommended number of tablets consistently.

In the aspirin group, 1.6 per cent developed preterm preeclampsia, compared to 4.3 per cent in the placebo group.

Those who took aspirin also had a 62 per cent reduced risk of preterm birth (delivery before 37 weeks of gestation) due to preeclampsia.
The researchers said that the findings provided definitive proof of aspirin’s effect on preeclampsia and called for it to be routinely prescribed to women at risk of getting the disease.

“The results show that aspirin can prevent preeclampsia in high risk pregnancies. I hope that they will alter clinical practice and improve pregnancy outcomes for mothers and their babies,” said Professor David Wright, from the University of Exeter Medical School.

SECOND LEADING CAUSE OF MATERNAL MORTALITY

Preeclampsia is a complication that occurs during pregnancy, characterised by high blood pressure and protein in urine.

It usually affects women during the second trimester or soon after delivery, and is the second leading cause of maternal mortality (death of a woman during pregnancy, termination of pregnancy, childbirth, or within 42 days after childbirth) after post-partum haemorrhage.

The Kenya Demographic and Health Survey, 2014, estimates that 5,000 to 6,000 women in Kenya die while giving birth every year.

ONE IN FOUR INFANTS AFFECTED

Further, according to data from a 2016 report compiled by Ending Preeclampsia, a project of the Population Council, 19 per cent of maternal deaths in Kenya are linked to hypertensive disorders. Globally, preeclampsia and other hypertensive disorders of pregnancy are estimated to cause 76,000 maternal deaths and 500,000 infant deaths.

Preeclampsia can lead to seizures and other complications that may lead to the death of the mother or the baby, or both.

It is estimated that one in four infants born prematurely dies as a result of the mother’s preeclampsia or eclampsia, a complication of preeclampsia characterised by seizures leading to a coma, and posing a threat to the life and health of a pregnant woman and that of her unborn baby.

Preeclampsia reduces the flow of blood through the placenta, thus restricting the flow of oxygen and nutrients to the foetus, which leads to restricted growth.

SYMPTOMS

• Persistent headache
• Abnormal swelling in hands and face
• Sudden weight gain
• Changes in vision
• High blood pressure
• Protein in urine
• Abnormal liver enzyme levels
• Abnormal platelet levels

Preeclampsia symptoms should be taken seriously because the condition can lead to seizures and other complications that may lead to the death of the mother, the infant or both.

About six per cent of women develop mild preeclampsia, which can be managed, while two per cent develop severe, life-threatening preeclampsia. The risk of complications is higher with severe preeclampsia, and when the condition develops in early pregnancy.
There is no known cause for preeclampsia, but certain factors like family history of preeclampsia, history of high blood pressure, diabetes, kidney disease, obesity, multiple pregnancies and first-time pregnancy are considered risky.
The cure for preeclampsia is delivery of the baby, but if caught early, it can be managed.
For mild preeclampsia, doctors recommend bed rest, reduction of salt intake, drinking more water, regular checkups and in some cases, drugs to lower blood pressure.
The World Health Organisation already recommends low-dose aspirin for the prevention of pre-eclampsia in women at high risk and recommends it be started before 20 weeks of pregnancy.