The Impact of Universalizing Aspirin Prophylaxis on Treatment Provision for High-Risk Pregnant Patients

Abstract

Objective

Low-dose aspirin is an established preventive strategy for reducing the risk of preeclampsia in patients with designated risk factors.

Study Design

This prospective observational study evaluated trends in aspirin prescription rates in a multihospital health system over a 10-month period during which a policy to offer low-dose aspirin universally was instituted.

Results

A total of 11,382 patients were included and an interrupted time series was used to analyze rates of aspirin prescriptions ordered by 16 weeks, before and after implementation of the universal policy. There were statistically significant increases in aspirin prescription rates for the entire cohort (incidence rate ratio [IRR]: 2.93; 95% confidence interval [CI]: 2.13–4.04) and for a high-risk subcohort including patients with chronic hypertension, pregestational diabetes, and/or multiple gestation (IRR: 1.48; 95% CI: 1.26–1.76).

Conclusion

Instituting a policy to offer universal low dose aspirin during pregnancy resulted in significantly increased utilization among patients with high-risk indications for aspirin.

Key Points

• A universal aspirin policy led to a significant increase in aspirin use across the cohort.

• There were also significant increases among high-risk patients including those with hypertension and diabetes.

• Universal aspirin may lower risk more broadly and improve usage among high-risk patients.

Keywords

aspirin - preeclampsia - quality improvement

Publication History

Received: 11 March 2025

Accepted: 24 March 2025

Accepted Manuscript online:
25 March 2025

Article published online:
30 April 2025

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