Acetylsalicylic acid during pregnancy

Is acetylsalicylic acid safe during pregnancy?

Acetylsalicylic acid (ASA) belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). This is a group of medications that are used for colds or pain, among other things. As a rule, medication from this group should be avoided during pregnancy in the first and third trimester. The drug of choice for pregnant women with similar symptoms during pregnancy is paracetamol. However, acetylsalicylic acid is also used by expectant mothers. It is a recognised medication for the prevention of pre-eclampsia during pregnancy.

Read more: Pre-eclampsia during pregnancy

Who should use acetylsalicylic acid during pregnancy?

Acetylsalicylic acid in pregnancy is recommended for women who have risk factors for pre-eclampsia or who have been found to be at increased risk of pre-eclampsia during a first trimester scan. It is part of the mandatory first trimester ultrasound examination during pregnancy, which is known as the composite test. Based on the ultrasound scan and parameters such as the expectant mother's medical history and the results of blood tests - beta-HCG, PAPP-A and sometimes PlGF - a special system calculates the risk of pre-eclampsia during pregnancy in addition to the risk of chromosomal abnormalities. If the calculated risk exceeds 1:150, supplementation with acetylsalicylic acid at a dose of 150 mg is recommended.

Acetylsalicylic acid should also be taken by expectant mothers who:

• suffer from chronic high blood pressure
• suffer from type 1 or type 2 diabetes
• suffer from chronic kidney failure
• have had high blood pressure in previous pregnancies
• suffer from an autoimmune disease such as lupus or antiphospholipid syndrome

When can acetylsalicylic acid be used during pregnancy?

It is very important that prophylaxis is carried out before the 16th week of pregnancy, when the placenta and blood vessels are not yet fully formed. Acetylsalicylic acid is generally used until the 36th week or until pre-eclampsia is diagnosed. This prophylaxis is considered effective in around 80 % of cases [1].

How is acetylsalicylic acid taken during pregnancy?

Acetylsalicylic acid should only be taken by pregnant women who have been advised to do so by their gynaecologist. You should not take any medication on your own during pregnancy. To prevent pre-eclampsia, it is recommended to take Apsirin 150 mg daily at bedtime. The medication should be started before the 16th week of pregnancy (optimally around the 12th week) and continued until the 36th week.

[1] Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med.