USPSTF Recommendation Regarding Aspirin Use in Pregnancy at High-Risk of Preeclampsia Interview with:

Dr. Caughey

Aaron B. Caughey, M.D., M.P.P., M.P.H., Ph.D.
Professor and ChairDepartment of Obstetrics and Gynecology
Associate dean for Women’s Health Research and Policy
Oregon Health & Science University in Portland, OR.
Founder and Chair, Centers for Disease Control and Prevention–funded
Oregon Perinatal Collaborative What is the background for this study? What are the main findings?

Response: Preeclampsia is one of the most serious health problems that can occur during pregnancy. It can lead to preterm birth, and in some cases even death of the pregnant person and their baby.

The Task Force looked at the latest available evidence and found that low-dose aspirin can help prevent preeclampsia in pregnant people who are at highest risk, and it can also protect their babies. This new final recommendation is consistent with the Task Force’s 2014 recommendation statement and has the potential to save many lives. What should readers take away from your report?

Response: This recommendation is only for people who have been pregnant for more than 12 weeks and are at high risk for preeclampsia. Before taking low-dose aspirin, pregnant people should talk to their clinician about their risk. Those at highest risk include people who have had preeclampsia in a previous pregnancy; people who are pregnant with more than one baby; and people with chronic conditions such as diabetes, high blood pressure, lupus, or kidney disease. What recommendations do you have for future research as a result of this work?

Response: More studies are needed on how to bet recognize which pregnant people are at increased risk for preeclampsia so that even more can be done to prevent it. Further research is also needed in populations that are most affected by preeclampsia, including pregnant Black people. Black people are at a significantly higher risk for developing and dying from preeclampsia due to a variety of social and health inequities. The Task Force is committed to addressing these inequities and is calling for more research on how best to prevent preeclampsia in pregnant Black people.

Additionally, the Task Force is calling for more research on how much aspirin pregnant people should take. The USPSTF is currently recommending 81 mg per day because it is available over the counter and is a reasonable amount for pregnant people, but some studies show a higher dosage may be more effective. More research is needed in this area. Is there anything else you would like to add?

Response: There is an emerging consensus that pregnant people at high-risk for preeclampsia should take low-dose aspirin to prevent the condition. The Task Force looked at new evidence from additional studies that clearly shows low-dose aspirin reduces the risk of babies dying from preeclampsia. This final recommendation statement can help prevent preeclampsia and ultimately save lives. No disclosures. 


US Preventive Services Task Force. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(12):1186–1191. doi:10.1001/jama.2021.1478

Henderson JT, Vesco KK, Senger CA, Thomas RG, Redmond N. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;326(12):1192–1206. doi:10.1001/jama.2021.8551

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Last Updated on October 6, 2021 by Marie Benz MD FAAD