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The Evidence of Aspirin Use in Prevention of Adverse Pregnancy Outcomes (APOs): Should It Be Continued Long Term After an APO?

  • Aziz, Aleha1
  • Thompson, Jacqueline2
  • Gyamfi-Bannerman, Cynthia1
  • D’Alton, Mary1
  • Wapner, Ronald1
  • Bello, Natalie A.3
  • 1 Columbia University Irving Medical Center, New York, NY, USA , New York (United States)
  • 2 Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA , New York (United States)
  • 3 Columbia University Irving Medical Center, 630 West 168th Street, P&S 10-445C, New York, NY, 10032, USA , New York (United States)
Published Article
Current Treatment Options in Cardiovascular Medicine
Springer US
Publication Date
Jun 11, 2021
DOI: 10.1007/s11936-021-00936-z
Springer Nature
  • Topical Collection on Reproductive Health and Cardiovascular Disease


Purpose of reviewAspirin is one of the only proven therapeutic options for the prevention of preeclampsia, an important adverse pregnancy outcome with detrimental short- and long-term consequences to a woman’s health. The goal of this review is to provide information about the current recommendations for the use of aspirin to prevent preeclampsia and whether there is evidence for postpartum continuation.Recent findingsPreeclampsia is linked to the development of future cardiovascular disease and adverse outcomes in women including stroke, ischemic heart disease, and heart failure. This is likely due to vascular dysfunction and inflammation as their shared pathophysiology. By decreasing vasoconstriction, aspirin targets these pathways, inhibiting cyclooxygenase-1 activity and thereby the synthesis of thromboxane A2. Low-dose aspirin use during pregnancy has been shown to decrease the frequency of preeclampsia and other adverse pregnancy outcomes such as fetal growth restriction and preterm birth.SummarySince adverse pregnancy outcomes and preeclampsia in particular significantly increase the risk for future cardiovascular disease, low-dose aspirin could have the potential to decrease onset and severity of adverse cardiac outcomes in young women. Improving cardiovascular indicators in reproductive-aged women, a demographic that unlike other populations (older, male) has experienced recent substantial increases in cardiovascular disease, has important public health implications.

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