Background

Pregnancy Loss

Pregnancy loss occurs in up to 30% of conceptions, affecting 1 in 10 women. Women who experience loss are at higher risk of subsequent losses and other adverse pregnancy outcomes, including:

• Preterm birth
• Preeclampsia
• Gestational diabetes
• Placental abruption

A history of pregnancy loss is also linked to cardiovascuar morbidity and earlier mortality, especially death from coronary heart or cerebrovascular disease. Potential consequences for pregnancy loss include severe anxiety, depression, and social withdraw, which can be persistent even after the birth of a healthy child. 

Preeclampsia

Preeclampsia is a great threat to maternal and offspring health and can put both the pregnant person and baby at risk of serious morbidity or mortality. It develops in 2-8% of pregnancies in the U.S. In the Philadelphia metro area, preeclampsia develops in 11% of pregnancies and up to 20-30% when including less severe cases of gestational hypertension. 

Preeclampsia is characterized by new onset hypertension during pregnancy associated with end-organ damage after 20 weeks gestation. It is also a multisystem, progressive condition that can lead to serious neurologic, pulmonary, hematologi, kidney, and liver complications, or even death in the pregnant person.

Aspirin in Pregnancy

Currently, the standard of care for pregnancy with aspirin at Penn Medicine is to take a low dose (81mg) aspirin tablet daily starting at 12 weeks gestation until delivery. This regimen helps prevent preeclampsia, and is practiced by the American College of Obtetrics and Gynecology (ACOG). Researchers believe that a slightly higher dose of aspirin starting earlier in pregnancy can greatly reduce the ongoing burden of preeclampsia, as well as pregnancy losses.