Half of Moms-to-be with Pre-Eclampsia Miss Out on Preventive Aspirin

Half of the pregnant women who are at risk of pre-eclampsia are missing out on aspirin that can help prevent the condition, reports a new study. The findings of the study are published in the journal Drug and Therapeutics Bulletin.//

Making aspirin available from local pharmacies could help ward off the condition, says consultant obstetrician Dr. Joanna Girling of West Middlesex University Hospital, London.

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‘Women at risk of pre-eclampsia should start to take preventative low-dose aspirin at 12 weeks of pregnancy because the dangerously high blood pressure condition is the leading cause of restricted fetal growth, premature birth, and stillbirth, and it raises the risk of hospital admission for the expectant mother before the birth. ’
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Pre-eclampsia is the leading cause of premature birth, restricted fetal growth, and stillbirth and it increases the risk of hospital admission for the expectant mother before the birth.

Risk factors include: chronic high blood pressure; underlying kidney disease; autoimmune disease such as rheumatoid arthritis; high blood pressure in a previous pregnancy; diabetes; older age (40+); obesity; more than ten years since the previous pregnancy; or a family history of pre-eclampsia.

National guidelines recommend that women at risk of pre-eclampsia should begin to take preventive low dose aspirin at 12 weeks of pregnancy.

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"So why is it that despite compelling evidence for its benefit and safety, more than 50% of eligible pregnant women never start aspirin?" asks the author.

Concerns about taking any drugs during pregnancy and logistical issues, such as midwives in most maternity units not having legal powers to prescribe or supply aspirin, may account for the figures, she suggests.

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When midwives can't prescribe, they advise mums-to-be to see their local GP to get a prescription, but this obviously takes time, risking delays in the start of preventive treatment, or not starting it at all, says Dr. Girling.

The easiest option would be to enable at-risk women to obtain supplies of low dose aspirin from their local pharmacy. It could be a lot cheaper than the "unnecessary branded pregnancy-related nutrients and supplements that many women choose to buy," she suggests.

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But the snag is that many pharmacists can't legally sell aspirin to ward off pre-eclampsia because it is not officially marketed for the treatment of the condition.

While some may be concerned that this suggests the use of aspirin for pre-eclampsia is unsafe, the absence of an official license for this indication is most likely for commercial reasons, because it's unlikely to be financially worthwhile, explains Dr. Girling.

But it makes no medical, financial, or common sense to disallow access to the drug in local pharmacies, she contends.

"If we are serious about increasing uptake of a nationally recommended, evidence-based, life-saving, low-cost intervention, how about developing a national [protocol] to allow community pharmacists to supply low-dose aspirin to women who are at risk of pre-eclampsia," she suggests.

Source-Eurekalert