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Offering aspirin to all pregnant women at the earliest opportunity could reduce severe pre-eclampsia risk by almost one-third, study results have revealed.
Presented at the Society for Maternal-Fetal Medicine 2026 Pregnancy Meeting on 11 February 2026, the study compared the outcomes of 18,457 pregnant women whose prenatal care and deliveries took place at Parkland Hospital in Dallas, Texas, between April 2020 to July 2025.
The findings showed that all patients presenting for prenatal care at 16 weeks or fewer of pregnancy from August 2022 were offered 162mg daily aspirin.
Prior to August 2022, “aspirin was not recommended regardless of risk factors”, the study report said.
“Pre-eclampsia with severe features (SPE) was a clinical diagnosis with administration of magnesium sulfate for severe hypertension or lab abnormalities,” it added.
Patients who received daily aspirin had a 29% lower rate of severe pre-eclampsia (7.12% versus 5.19%, OR 0.71 (0.66-0.78), p<0.001) compared to those who had not.
Of those who did develop severe pre-eclampsia, women in the aspirin cohort developed it later in pregnancy compared to the control group, the researchers said.
There was no increase in maternal haemorrhage or placental abruption among those who took aspirin, the results showed.
Elaine L Duryea, associate professor at the Department of Obstetrics and Gynaecology at the University of Texas Southwestern Medical Center, and lead researcher commented “Implementation of directly-dispensed aspirin in this high-risk pregnant population appeared to delay the onset, and for some patients completely prevent the development of preeclampsia with severe features.
“While we cannot be sure that similar effects will be observed in other patient populations, there was no evidence of harm caused by aspirin administration.”
Zoë van Zuylen, lead women and neonatal pharmacist at Imperial College Healthcare NHS Trust, commented: “This study supports that aspirin is safe and effective in reducing [pre-eclampsia] and women in the UK should be encouraged to take aspirin to reduce the risk of [pre-eclampsia] if recommended by a healthcare professional.”
van Zuylen added that women in the UK are assessed for risk factors at their booking appointment, at around nine or ten weeks of pregnancy, and aspirin is recommended to all women with moderate-to-high risk of developing pre-eclampsia.
It is recommended that they start taking it at 12 weeks, or after their first scan, she added.
Highlighting a Specialist Pharmacy Service patient group direction for the supply of aspirin tablets to individuals at risk of pre-eclampsia during pregnancy, van Zuylen said that the recommended dose is 75mg or 150mg “depending on weight and particular risk factors”.
“There is some mixed evidence for the optimal dose, but generally it is agreed that doses equal to or greater than 75mg provide benefit,” she said.
“It is also agreed that starting before 16 weeks provides benefit and that adherence is important. There is some suggestion that taking it at night is more affective due to circadian effects.”
Read more: ‘Pre-eclampsia: identification and management’
