Aspirin During Pregnancy: Safe Or Not?

Pregnant women are usually advised to stay away from aspirin, but new research suggests that low-dose or baby aspirin may be beneficial in some circumstances. Low-dose aspirin is recommended for pregnant women with certain medical conditions such as high blood pressure, diabetes, and kidney disease. It can also reduce a woman's risk of developing preeclampsia and other hypertensive disorders during pregnancy. However, high-dose aspirin is not recommended for pain relief during pregnancy as it may affect the baby's circulation, especially after 30 weeks.

Low-dose aspirin may be prescribed to prevent pre-eclampsia

Low-dose aspirin (60-150 mg daily) may be prescribed to prevent pre-eclampsia. The usual dose during pregnancy is 81 mg daily, although there is some evidence that 150 mg may be more effective. Low-dose aspirin is considered safe to take throughout pregnancy and is not expected to increase the risk of miscarriage or harm the baby. It is recommended for pregnant individuals at high risk of preeclampsia with one or more of the following risk factors:

• History of preeclampsia, especially when accompanied by an adverse outcome
• Multifetal gestation
• Chronic hypertension
• Pregestational type 1 or 2 diabetes
• Autoimmune disease (e.g. systemic lupus erythematous, antiphospholipid syndrome)

Low-dose aspirin prophylaxis should also be considered for pregnant individuals with more than one of several moderate-risk factors:

• Obesity (BMI > 30)
• Family history of preeclampsia
• Age 35 years or older
• Personal history factors (e.g. low birth weight, previous adverse pregnancy outcome)
• In vitro fertilisation

Low-dose aspirin should be initiated between 12 and 28 weeks of gestation, optimally before 16 weeks, and continued daily until delivery. It is important to note that low-dose aspirin does not guarantee the prevention of preeclampsia and that paracetamol is recommended as the first choice of painkiller for pregnant women.

High-dose aspirin may affect the baby's circulation

High-dose aspirin is not recommended for pain relief during pregnancy as it may affect the baby's circulation. This risk is especially pronounced if high-dose aspirin is taken for long periods of time after 30 weeks of pregnancy. While there is no strong evidence that high-dose aspirin is unsafe during the first 6 months of pregnancy (up to 30 weeks), other painkillers may be more suitable and potentially less harmful to the baby.

If you have taken high-dose aspirin after 30 weeks of pregnancy, especially if you have taken it for a long time, tell your doctor or midwife as soon as possible so they can check on the health of your baby.

Low-dose aspirin, on the other hand, is considered safe to take throughout pregnancy and may even be prescribed by a doctor or midwife to help prevent pre-eclampsia. The typical dose of low-dose aspirin during pregnancy ranges from 60 to 150 mg daily, with 81 mg being the usual dose.

It is important to consult with a healthcare provider before taking any medication during pregnancy, as they can advise on the benefits and risks of the treatment.

Paracetamol is the recommended painkiller for pregnant women

Paracetamol has been well-studied, and there is no evidence that it harms the baby. It passes into breast milk in very small amounts, and the amount the baby receives is far less than a direct dose. It has been used during breastfeeding for many years without any negative effects on children. However, it is always best to consult a doctor or midwife before taking any medication during pregnancy.

Although some studies suggest that paracetamol use during pregnancy might be linked to behavioural problems in children, these studies have been deemed unreliable by experts. Overall, there is no proof that paracetamol exposure in the womb affects a child's behaviour. The available evidence suggests that any possible harms of paracetamol are likely dose-related, with most increased risks linked to use in pregnancy for more than two or four weeks.

Paracetamol is the best choice for the short-term treatment of pain and/or fever during pregnancy. It is important to identify the cause of the pain or fever, and non-medication treatments should be considered before or in addition to paracetamol. When medication is necessary, paracetamol is considered the safest option.

Low-dose aspirin (60-150mg daily) may be prescribed by a doctor or midwife to prevent pre-eclampsia and is safe to take throughout pregnancy. However, high-dose aspirin is not recommended for pain relief during pregnancy as it may affect the baby's circulation, especially after 30 weeks. If paracetamol does not control the pain, it is recommended to consult a doctor before taking aspirin.

Aspirin may be prescribed to pregnant women with certain medical conditions

Aspirin is typically not recommended for pregnant women. However, low-dose aspirin, ranging from 60 to 150 mg daily, may be prescribed to pregnant women with certain medical conditions. The usual dose during pregnancy is 81 mg daily, taken at bedtime.

Low-dose aspirin can be prescribed to reduce the risk of preeclampsia and other hypertensive disorders in pregnancy. Preeclampsia is associated with alterations in the immune system during pregnancy. Risk factors for preeclampsia include high blood pressure, diabetes, small vascular diseases like lupus, and a history of preeclampsia. Low-dose aspirin may also be recommended for pregnant women with kidney disease, as well as those with higher risk factors for hypertensive disorders, such as first-time pregnancy, being 35 years or older, or carrying twins or triplets.

While low-dose aspirin can provide benefits for pregnant women with these specific risk factors, it should be taken under medical supervision. Even in low doses, aspirin can affect how platelets function, making them less likely to stick together, and potentially causing ulcers or bleeding problems. Therefore, it is important to consult a healthcare provider before taking aspirin during pregnancy.

Aspirin is not usually recommended while breastfeeding

Aspirin passes into breast milk in small amounts. There is a possible link between aspirin and Reye's syndrome in children. Reye's syndrome is associated with aspirin administration to infants with viral infections, but the risk of Reye's syndrome from salicylate in breast milk is unknown.

If a nursing mother uses aspirin, the infant should be monitored for bruising and bleeding. If the baby develops a viral infection or a high temperature, the mother should stop taking aspirin until the baby is well again. Alternatively, the mother can express milk, throw it away, and give the baby formula until they are better.

If other painkillers are not suitable, a doctor may advise taking aspirin. It is important to talk to a healthcare provider about all your breastfeeding questions.

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