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Low-Dose Aspirin during Pregnancy and Postpartum Bleeding
Kelsey J White1, Moeun Son1, Lisbet S Lundsberg1
1Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut.
American Journal of Perinatology
|May 21, 2023
Summary
Low-dose aspirin (LDA) use in pregnancy may be linked to postpartum bleeding. Discontinuing LDA less than seven days before delivery increases bleeding risk, warranting further research on optimal timing.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Preeclampsia prevention often involves low-dose aspirin (LDA).
- The association between LDA and postpartum blood loss requires clarification.
Purpose of the Study:
- To investigate the association between daily 81 mg aspirin for preeclampsia prevention and postpartum blood loss.
Main Methods:
- Retrospective cohort study of 16,980 deliveries.
- Comparison of patients prescribed LDA versus those not prescribed LDA.
- Primary outcome: composite of postpartum hemorrhage (PPH), estimated blood loss >1,000 mL, or red blood cell transfusion.
Main Results:
- LDA use was not significantly associated with the composite outcome after adjustment (aOR: 1.1).
- However, LDA use remained associated with PPH (aOR: 1.3).
- Discontinuation of LDA less than 7 days before delivery was linked to increased postpartum blood loss.
Conclusions:
- Potential association between LDA use and increased postpartum bleeding risk.
- Caution advised for LDA use outside guidelines; further research on optimal timing is needed.
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