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Could Aspirin Be a Protective Factor and a Factor Promoting Placental Abruption?
Emmanuel Bujold1, Kypros H Nicolaides2
1Department of Obstetrics and Gynecology, Research Center of CHU de Québec - Laval University, Quebec City, QC.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|May 27, 2026
Summary
Aspirin use in pregnancy may not prevent placental abruption, despite preventing preeclampsia. Further research is needed to clarify risks and optimal aspirin use for pregnant individuals at risk.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Pharmacology in Pregnancy
Background:
- Placental abruption is linked to deep placentation disorders and preeclampsia.
- Prophylactic aspirin (150-162 mg daily from 11-14 weeks) prevents preterm preeclampsia.
- The effect of aspirin on placental abruption risk is unclear, with some literature suggesting a potential increase in risk.
Purpose of the Study:
- To clarify the association between aspirin use and placental abruption.
- To evaluate the current understanding of aspirin's role in preventing placental abruption.
- To inform clinical practice regarding aspirin prescription in at-risk pregnancies.
Main Methods:
- Literature review of studies investigating aspirin and placental abruption.
- Analysis of existing data on aspirin's efficacy and safety in pregnancy.
- Consideration of the implications of current evidence for clinical guidelines.
Main Results:
- The prophylactic use of aspirin for preeclampsia prevention does not have a clearly established benefit for preventing placental abruption.
- Evidence suggests aspirin might potentially increase the risk of placental abruption.
- Current literature is inconclusive, necessitating further investigation.
Conclusions:
- Aspirin use should be limited to pregnant individuals genuinely at risk for preeclampsia.
- Randomized trials are needed to assess the efficacy of reducing or stopping aspirin in the late second trimester.
- Further research is crucial to establish optimal aspirin dosing and timing for placental abruption prevention.
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