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Women’s health and midwifery
Risk of aspirin among pregnant women
  1. Hanumanthu R Jogu1,
  2. Pradeep Yarra2
  1. 1 Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
  2. 2 Internal Medicine, University of Kentucky, Lexington, Kentucky, USA
  1. Correspondence to Pradeep Yarra, Internal Medicine, University of Kentucky, Lexington, Kentucky, USA; pya227{at}

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Commentary on: Hastie R, Tong S, Wikström AK, et al. Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study. Am J Obstet Gynecol. 2020 Jul 17:S0002-9378(20)30737-7. doi:10.1016/j.ajog.2020.07.023.

Implications for practice and research

  • Using aspirin for prevention of pre-eclampsia is associated with increased risk of postpartum haemorrhage, postpartum hematoma and possibly neonatal intracranial haemorrhage.

  • More liberal or universal administration of aspirin may have more risk than benefits due to bleeding risk, but still strongly advised in high-risk pre-eclampsia pregnant women.

  • Future prospective studies are needed to determine bleeding risks with widespread use of aspirin in pregnancy.


Aspirin is widely offered to pregnant women at risk of developing pre-eclampsia, secondary to its anti-inflammatory and antiplatelet properties.1 There has been a trend towards increasing the use of aspirin universally to pregnant women, secondary to perceived safety of aspirin.2 Recent large randomised control trials report …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.