This systematic review was conducted to support the U.S. Preventive Services Task Force (USPSTF) in updating its 1996 recommendation. The authors conclude that for women at high risk for preeclampsia, available evidence indicates modest effects but important benefits of daily low-dose aspirin for prevention of the condition and consequent illness. They note that no significant perinatal or maternal harms were identified, but that rare harms could not be ruled out, and further research is needed to address remaining uncertainties.
In its clinical guideline on the management of hypertensive disorders during pregnancy, NICE recommends the use of aspirin 75mg daily (off-label) from 12 weeks of pregnancy to the birth of the baby in women who are at a high-risk of pre-eclampsia (hypertensive disease during a previous pregnancy; chronic kidney disease; autoimmune disease; type 1 or type 2 diabetes; chronic hypertension) or who have two or more moderate risk factors (first pregnancy; age 40 years or older; pregnancy interval of more than 10 years; BMI ≥35 kg/m2 or more at first visit; family history of pre-eclampsia; multiple pregnancy).