Preeclampsia affects 5-10% of all pregnancies globally and is the indication for 20% of labour inductions and 15% of caesarean sections. Women with pre-existing diabetes have been found to have a higher risk of developing preeclampsia with recent data suggesting that 15-20% of pregnancies in women with type 1 diabetes and 10-14% of pregnancies in women with type 2 diabetes develop preeclampsia. This risk, however, increases substantially to 40% with the presence of diabetic nephropathy.
Aspirin has been used in the prevention of preeclampsia in high-risk women for over 40 years. The data on its efficacy, however, has been largely variable with data suggesting a risk reduction of 10-40%. In recent times, however, aspirin has been shown to have a risk reduction of up to 60%. The variability observed over the years has been largely attributed towards the heterogeneity of these studies.
This presentation focuses on the use of aspirin in the prevention of preeclampsia with emphasis on the proposed mechanism of action and factors that influence its efficacy as a prophylactic agent in the prevention of preeclampsia amongst high-risk pregnant women.