Aspirin During Pregnancy: When To Take And When Not To

Aspirin-containing OTC medications may not be safe during pregnancy, especially in the third trimester.

Medically reviewed by Subhashis Samajder, MS, DNB Subhashis Samajder Subhashis SamajderMS, DNB Follow MomJunction on LinkedinFollow MomJunction on YouTube Specialty: Obstetrics & GynaecologyExperience: 9 years
Written by , MSc shreeja pillai MSc Follow MomJunction on Linkedin Specialty: Pharma and HealthExperience: 2.5 years
Edited by , M.Sc. (Food & Nutrition), MBA Swati Patwal M.Sc. (Food & Nutrition), MBA Follow MomJunction on Linkedin Specialty: Food, Nutrition and HealthExperience: 10 years
Fact-checked by , M.Pharm, PhD Dr. Joyani Das M.Pharm, PhD Follow MomJunction on Linkedin Specialty: Pharma, Health and WellnessExperience: 3.5 years
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A Pregnant Woman Taking Aspirin

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Many pregnant women may experience headaches and nausea during the course of nine months, especially during the first trimester. While usually, we do not hesitate to consume available over-the-counter medicines such as aspirin to deal with these problems, an expecting mother may want to know if it is safe to use aspirin in pregnancy. Read through this post to learn more about the indications, contraindications, and safer alternatives to aspirin during pregnancy.

In This Article

What Is Aspirin?

It is commonly prescribed to treat minor pains, fever, and inflammation.

Image: Shutterstock

Aspirin, also known as acetylsalicylic acid (ASA), is a non-steroidal anti-inflammatory drug (NSAID). It is commonly prescribed to treat minor pains, fever, and inflammation. In some cases, it is used as a blood thinning medication to treat heart attacks, strokes, and chest pain due to its anticoagulant properties (1). This medication is available under different brand names including Ascriptin, Aspilet, Angettes 75, Disprin, Durlaza, Caprin, Ecpirin, Resprin, Halfprin, Nu-Seals and Micropirin (2).

Can You Take Aspirin During Pregnancy?

A daily low-dose aspirin will not cause any risk of miscarriage.

Image: Shutterstock

Low dose(60-150mg) aspirin is safe during pregnancy as per ACOG guidelines.

Here are some side effects associated with aspirin intake during pregnancy.

In early pregnancy:

  • A daily low-dose aspirin will not cause any risk of miscarriage. However, a high dose of aspirin (more than 150mg/day) could increase the risk of fetal malformations or congenital birth defectsiA structural or functional abnormality present from birth.  (3).

In late pregnancy:

  • In the last trimester, aspirin leads to premature closure of the fetal ductus arteriosus and may cause pulmonary hypertension (the blood vessel that passes blood to the baby’s lungs before birth), thus delaying labor. However, robust evidence is lacking (4).

While a few doses of baby aspirin may not cause harm to you or your baby, prolonged usage of adult doses may have adverse effects.

protip_icon Quick fact
Low-dose aspirin helps prevent pre-eclampsiaiA pregnancy disorder characterized by high blood pressure, water retention, and protein content in urine. -related adverse outcomes, such as preterm birth, small-for-gestational-age (SGA), intrauterine growth restriction (IUGR), and perinatal mortalityiDeath of a fetus or a neonate just a few days before the birth, around birth, or soon after birth. (12).

When Is Aspirin Advisable?

"It can be advised for pregnant women with a history of chronic hypertension. "

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While taking aspirin during pregnancy can be risky, it has been found to be safe in certain conditions. Your healthcare provider may advise a low dosage aspirin if you have:

  • History of gestational hypertension, eclampsia or severe pre-eclampsia related preterm birth, low birth weight, or FGR or IUD (5)
  • History of abruption due to PET
  • History of chronic hypertension
  • Hughes syndrome, also called antiphospholipid syndrome (APLS), is an immune system disorder that causes blood clots or thrombosis (6).
  • Preeclampsia, which usually develops in the third trimester (7). The US Preventive Services Task Force (USPSTF), preeclampsia complicates about 4% of US pregnancies, significantly impacting maternal and infant health outcomes. Sara, a mom blogger who experienced preeclampsia in her first pregnancy, shares the measures she took to prevent this condition in subsequent pregnancies. She says, “I started taking baby aspirin at around 12 and a half weeks to prevent preeclampsia. I had preeclampsia with my first baby, so I continued to take it with all my other children to prevent it from happening again (i).” Seeking medical guidance and timely intervention is necessary to avoid adverse outcomes.
  • Diabetes or kidney disorders (8)
  • Aspirin can be considered when two or more moderate risk factors are present such as, age more than 40, BMI more than 35kg/sqm, nulliparous, pregnancy interval of more than 10 years, and twin pregnancy.
  • In addition to the conditions mentioned above, there may be cases where aspirin administration during pregnancy might play a crucial role. Katherine Pickering Antonova shares her encounters with multiple miscarriages and how aspirin helped her. She says, “My male OBGYN, a very big name in Manhattan, dismissed SEVEN of these (missed miscarriages) before I had an accidental appointment with a female junior doctor in his office who was horrified. She put me on very simple and safe baby aspirin and progesterone, and by the next month, I was pregnant with my youngest, and the whole string of miscarriages was over (ii).”

Hence, the use of aspirin during pregnancy is a decision that should be made with careful consideration of individual circumstances and medical advice.

protip_icon Things to know
Aspirin may also be recommended for women with low pregnancy-associated plasma protein (PAPP-A)iA protein produced by the placenta during pregnancy. screening blood test or a previous history of stillbirth (13).

What If You Have Already Taken Aspirin During Pregnancy?

If you have been taking aspirin for a long time or were on a high dosage when you got pregnant, let your practitioner know about it. They will also assess maternal health and fetal development to decide whether you should continue it or use an alternative.

Contraindication Of Aspirin During Pregnancy

Aspirin is not indicated under the following circumstances:

  • Aspirin allergy or hypersensitivity to other NSAIDSiA type of drug that reduces pain, fever, inflammation, and blood clot.
  • Nasal polyp or asthmatic patient as aspirin may cause bronchoconstrictioniNarrowing of the bronchial airways.
  • History of gastrointestinal bleedingiPresence of blood in the urine, also known as hematuria. or genitourinary bleedingiRelating to genital and urinary.

Is There Any Safer Alternative For Aspirin During Pregnancy?

Acetaminophen is a safer alternative to take for fever and pain during pregnancy.

Image: Shutterstock

Acetaminophen (Tylenol or paracetamol) is a safer alternative to take for fever and pain during pregnancy. But check with your practitioner before taking one (9).

Next, we address a few commonly asked queries about aspirin during pregnancy.

Frequently Asked Questions

1. Why is aspirin gastro-resistant tablet 50mg prescribed in pregnancy?

The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommend low dosage of Aspirin to women who are at a high risk of preeclampsia (high blood pressure) during pregnancy (10).

2. Can aspirin prevent pregnancy?

Aspirin cannot prevent pregnancy. However, it is found to increase the likelihood of conception for those who had a spontaneous abortion or a recent pregnancy loss (11).`

3. Can aspirin help you get pregnant?

Aspirin/ baby aspirin can help to retain pregnancy. Taking it before conception and during pregnancy can give you an extra boost if you are experiencing low-grade inflammation or if you have a rare condition called Antiphospholipid Antibody Syndrome (autoimmune disorder)iA type of autoimmune disorder that causes blood clots in arteries and veins. .

4. Does aspirin cross the placenta?

Aspirin can cross the placenta but according to the FDA, it can be safely used in low doses (14).

5. Does aspirin help with fetal growth restriction?

In women at risk of preeclampsia, studies have shown that low doses of aspirin could lower the likelihood of fetal growth restriction; however, there is insufficient evidence to support the use of low-dose aspirin in women with a history of fetal growth restriction alone (10).

Popping a pill for every pain while pregnant is not advisable. Moreover, before you take a medicine for every twinge, you must comprehend the safety and risks of medications such as aspirin during pregnancy. Aspirin is to be taken in low doses only if prescribed by your medical practitioner to manage any medical condition such as preeclampsia, maternal thrombosis, and diabetes in pregnancy. Further, you may speak to your doctor about your health and medical history to have a healthy pregnancy and stress-free delivery.

This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.

Infographic: How Aspirin Is Beneficial In Preventing Preeclampsia And Its Consequences?

Preeclampsia causes high blood pressure and excess protein in urine and may complicate a pregnancy. Low doses of aspirin (doses lower than what is used for analgesic action) have been found to prevent the condition. The infographic below gives a brief description of how aspirin helps.

aspirin during pregnancy (infographic)

Illustration: Momjunction Design Team

Key Pointers

  • ACOG recommends using low doses of aspirin (60-150 mg) during pregnancy as it is safe.
  • Taking over 150 mg per day in the early stages of pregnancy increases the risk of congenital abnormalities in the fetus.
  • In the third trimester, aspirin can cause pulmonary hypertension and premature closure of the fetal ductus arteriosus, which can lead to labor delay.
  • Low-dose aspirin may be prescribed during pregnancy for health conditions such as preeclampsia, diabetes, kidney disorders, Hughes syndrome, and others.
  • Acetaminophen is a safer alternative to aspirin during pregnancy.

If you’re pregnant and thinking about taking low-dose aspirin, let’s talk about the benefits and drawbacks of doing so.

Personal Experience: Source

MomJunction articles include first-hand experiences to provide you with better insights through real-life narratives. Here are the sources of personal accounts referenced in this article.

i. 13 weeks pregnant on baby aspirin to prevent preeclampsia!
https://youtu.be/LDyns3UhHzY?feature=shared

ii. Miscarriages and men.
https://uchechukwuajuzieogu.medium.com/miscarriages-and-men-1133cf918efb

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts;US Food and Drug Administration
2. Aspirin Drug Record; The Drug Gene Interaction Database.
3. Mother To Baby Medications and More During Pregnancy and Breastfeeding Ask The Experts; Organization of Teratology Information Specialists (OTIS).
4. Prescribing medicines in pregnancy; An Australian categorization of risk of drug use in pregnancy; Australian Drug Evaluation Committee.
5. Lecture 12 a: Complications of Pregnancy; John Hopkins Bloomberg School of Public Health.
6. Heilmann L, Von Tempelhoff GF, Pollow K; Antiphospholipid syndrome in obstetrics; US National Library of Medicine National Institutes of Health.
7. Jilian T Henderson, et.all, Low-Dose Aspirin for the Prevention of Morbidity and Mortality From Preeclampsia; US National Library of Medicine National Institutes of Health
8. Yoshihiko Saito, et.al; Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate; US National Library of Medicine National Institutes of Health.
9. Scand J Pain; Is acetaminophen safe in pregnancy? US National Library of Medicine National Institutes of Health.
10. Low-Dose Aspirin Use During Pregnancy; The American College of Obstetricians and Gynecologists.
11. Aspirin does not prevent pregnancy loss, NIH study finds; National Health Institutes of Health.
12. Use of Aspirin During Pregnancy to Prevent Preeclampsia; JAMA Network
13. Aspirin in pregnancy; NHS
14. Suchismita Dutta,et al; Molecular Targets of Aspirin and Prevention of Preeclampsia and Their Potential Association with Circulating Extracellular Vesicles during Pregnancy;US National Library of Medicine National Institutes of Health

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Subhashis Samajder
Subhashis Samajder MS, DNB
Dr. Subhashis Samajder, a consultant gynecologist-obstetrician with nine years of experience, is currently practicing at Narayana Multispeciality Hospital, Howrah. His area of expertise includes abortion, colposcopy surgery, hysterectomy, hysteroscopy, infertility treatment, and menopausal problems.

Read full bio of Subhashis Samajder
shreeja pillai
shreeja pillaiMSc
Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company.

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Swati Patwal
Swati PatwalM.Sc. (Food & Nutrition), MBA
Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

Read full bio of Swati Patwal
Dr. Joyani Das
Dr. Joyani DasM.Pharm, PhD
Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

Read full bio of Dr. Joyani Das