Low-Dose Aspirin for Preventing Pre-Eclampsia: Dueling Guidelines

The American College of Obstetricians and Gynecologists (ACOG) and the U.S. Preventive Services Task Force (USPSTF) have divergent guidelines for use of low-dose aspirin (81 mg daily) to prevent pre-eclampsia. ACOG recommends aspirin prophylaxis only for women with histories of pre-eclampsia necessitating delivery before 34 weeks and those with pre-eclampsia in ≥2 prior pregnancies, representing <1% of all pregnant women. The USPSTF recommends prophylaxis for all women with high risk factors for pre-eclampsia (e.g., diabetes, chronic hypertension, renal disease) and those with multiple moderate risk factors (e.g., nulliparity, obesity), representing about 25% of all pregnant women. These authors developed models to evaluate the relative cos…