Low-Dose Aspirin for Preventing Preeclampsia: What's the Optimal Strategy?

Daily low-dose aspirin initiated before 16 weeks of pregnancy can lower the occurrence of preeclampsia — but who should receive this treatment? In a simulation study, researchers tested four management strategies: 1) no aspirin; 2) aspirin for women deemed high-risk using biophysical markers such as uterine artery doppler; 3) aspirin for women deemed high-risk using USPSTF risk factors such as personal history of preeclampsia; and 4) universal aspirin.

Per 100,000 women, each treatment strategy yielded preeclampsia rates of 4.2% (1), 3.8% (2), 3.8% (3), and 3.5% (4). The total monetary costs were $39 million (1), $39 million (2), $28 million (3), and $20 million (4). In sensitivity testing, universal aspirin use had the lowest costs in 91% o…