Universal Low-Dose Aspirin Prescribing Strategy May be Beneficial for Preeclampsia Prevention
Research presented at ACOG 2025 showed 99% of pregnant women included in the analysis were eligible for aspirin, per ACOG guidelines.
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A universal low-dose aspirin (LDA) prescribing approach implemented at an urban wellness center significantly improved aspirin uptake among pregnant patients at risk for preeclampsia, according to findings presented at the 2025 ACOG Annual Clinical and Scientific Meeting.1
The retrospective quality improvement study was conducted at the SBH Wellness Center (SBH), where researchers transitioned from a risk-based prescribing model to a universal prescribing strategy in December 2023. The intervention presumed all obstetric patients as candidates for LDA beginning in the second trimester, aiming to close a well-documented prescribing gap identified by the Society for Maternal-Fetal Medicine.1
Between February and May 2024, investigators reviewed the electronic health records of 116 pregnant women at 12 to 28 weeks’ gestation. The analysis evaluated whether patients met the American College of Obstetricians and Gynecologists (ACOG) criteria for LDA eligibility, presence of risk factors for preeclampsia, and whether aspirin was prescribed.1,2
According to the results, of the 116 patients reviewed, 99% met ACOG criteria for low-dose aspirin use. The overall prescribing rate during the study period was 81%, with a slightly higher rate of 88% observed among patients with high-risk factors. Before the intervention, the LDA prescription rate was 30%. Following an initial education-focused intervention, the rate increased to 46%. Investigators observed that after implementation of the universal prescribing strategy, the rate rose further to 81%.1
The shift from selective, risk-based prescribing to a universal strategy led to a near doubling of aspirin use among eligible patients. The study authors noted that universal presumption of aspirin candidacy may be especially beneficial in underserved, low-income, urban communities where preeclampsia risk is elevated and targeted interventions may be inconsistently applied.1
“The rate of aspirin prescription increased from 46% in our last study to 81%, demonstrating that the shift from risk-based to universal prescription increased the number of eligible patients receiving aspirin,” researchers concluded. “Universal presumption of LDA eligibility could be beneficial for increasing aspirin prescription in lower-income urban communities with a similar patient demographic to that of SBH.”1
References:
1. Grimaldi MY, Boucaud DE, Odiase I, Argeros O. Increasing the use of low-dose aspirin for preeclampsia prevention through universal implementation [ID 1336]. Obstetrics & Gynecology. 2025;145:8S. doi:10.1097/AOG.0000000000005916.026
2. Low-dose aspirin use for the prevention of preeclampsia and related morbidity and mortality. American College of Obstetricians and Gynecologists. Published December 2021. Accessed June 18, 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/12/low-dose-aspirin-use-for-the-prevention-of-preeclampsia-and-related-morbidity-and-mortality
