Aspirin use during pregnancy
From: Miranda Brossart (miranda_brossart@und.nodak.edu)
Tue, 19 Mar 2002 16:24:52 -0600 (CST)
Hi, my name is Miranda Brossart and I am a nursing student at the
University of North Dakota. I am currently taking a maternal-newborn
nursing class and last week in lecture the controversial issue of using
aspirin to treat pre-eclampsia during pregnancy was brought up. I
decided to read up on it and found that my textbook authors, Olds,
London, and Ladewig (2000) suggest that it is reasonable to use low-dose
aspirin in women with a history of severe early onset pre-eclampsia.
However, they also warn that the use of aspirin can result in prolonged
pregnancy or labor if used regularly and too, that aspirin may increase
the risk of bleeding antepartally or at birth.
I did additional research on the effects of aspirin on pre-eclampsia and
pregnancy and found considerable controversy in some of the literature.
For example, Caritis, Sibai, and Hauth (1998) suggest that low-dose
aspirin does not reduce the risk of pre-eclampsia in high-risk
pregnancies, even though it is a recommended treatment. This particular
study examined the effects of low-dose aspirin on women who have a high
risk of pre-eclampsia. It concluded that low-dose aspirin did not
reduce the incidence of pre-eclampsia significantly or improve perinatal
outcomes in pregnant women at high risk of pre-eclampsia.
On the other hand, Knight, Duley, Henderson-Smart, and King (2001a)
assessed the effectiveness and safety of antiplatlet drugs for
prevention of pre-eclampsia and its consequences and concluded that most
of the evidence relating to low dose aspirin suggests that it is the
antiplatlet agent that should be used in clinical practice for
prevention of pre-eclampsia. However, these same authors also found
that a low dose aspirin study in pregnancy, the largest trial to date,
failed to confirm any worthwhile benefit and that previous systematic
reviews, all now out of date, concluded that although low dose aspirin
seems safe, it is not effective for most women (2001b).
Due to the controversy in the literature that I have found, I would
appreciate any feedback on the use of aspirin during pregnancy and its
effectiveness for treating pre-eclampsia. How often do you see it used
in your practice and have you witnessed any benefits or adverse
reactions due to its use during pregnancy?
References
Caritis, S., Sibai, B., Hauth, J. (1998). Low-dose aspirin to prevent
pre-eclampsia in women at high risk. New England Journal of Medicine,
338: 11, 701-705.
Knight, M., Duley, L., Henderson-Smart, D.J., & King, J.F. (2001a).
Antiplatlet agents for preventing and treating pre-eclampsia (Cochrane
Review). The Cochrane Library, Issue 1, Oxford: Update Software.
Knight, M., Duley, L., Henderson-Smart, D.J., & King, J.F. (2001b).
Antiplatlet drugs for prevention of pre-eclampsia and its consequences:
systematic review. British Medical Journal, 322, 329-333.
Olds, S., London, M., & Ladewig, P. (2000). Maternal newborn nursing:
A
family and community-based approach (6th ed.). New Jersey:
Prentice-Hall, Inc., 409.
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