• US Preventive Services Task Force, Karina W Davidson, Michael J Barry, Carol M Mangione, Michael Cabana, Aaron B Caughey, Esa M Davis, Katrina E Donahue, Chyke A Doubeni, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, Michael Silverstein, Melissa A Simon, James Stevermer, Chien-Wen Tseng, and John B Wong.
• Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York.
• JAMA. 2021 Sep 28; 326 (12): 1186-1191.

ImportancePreeclampsia is one of the most serious health problems that affect pregnant persons. It is a complication in approximately 4% of pregnancies in the US and contributes to both maternal and infant morbidity and mortality. Preeclampsia also accounts for 6% of preterm births and 19% of medically indicated preterm births in the US. There are racial and ethnic disparities in the prevalence of and mortality from preeclampsia. Non-Hispanic Black women are at greater risk for developing preeclampsia than other women and experience higher rates of maternal and infant morbidity and perinatal mortality.ObjectiveTo update its 2014 recommendation, the USPSTF commissioned a systematic review to evaluate the effectiveness of low-dose aspirin use to prevent preeclampsia.PopulationPregnant persons at high risk for preeclampsia who have no prior adverse effects with or contraindications to low-dose aspirin.Evidence AssessmentThe USPSTF concludes with moderate certainty that there is a substantial net benefit of daily low-dose aspirin use to reduce the risk for preeclampsia, preterm birth, small for gestational age/intrauterine growth restriction, and perinatal mortality in pregnant persons at high risk for preeclampsia.RecommendationThe USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication for preeclampsia after 12 weeks of gestation in persons who are at high risk for preeclampsia. (B recommendation).

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