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Meta-analyses of randomized trials indicate that low-dose aspirin has the strongest preventive effect against preterm preeclampsia when started in early pregnancy, particularly before 16 weeks. Benefit appears greater in women at high risk, while routine use in low-risk populations is not supported. For clinicians, prevention begins with accurate risk assessment using history and relevant maternal factors. Once aspirin is indicated, adherence and continuation through the recommended gestational window are important. Aspirin should not be used as treatment for established severe preeclampsia and does not replace blood-pressure monitoring, fetal surveillance or timely delivery. The evidence is particularly relevant to first-trimester counselling because the preventive opportunity is time-limited.
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Meta-analyses of randomized trials indicate that low-dose aspirin has the strongest preventive effect against preterm preeclampsia when started in early pregnancy, particularly before 16 weeks. Benefit appears greater in women at high risk, while routine use in low-risk populations is not supported. For clinicians, prevention begins with accurate risk assessment using history and relevant maternal factors. Once aspirin is indicated, adherence and continuation through the recommended gestational window are important. Aspirin should not be used as treatment for established severe preeclampsia and does not replace blood-pressure monitoring, fetal surveillance or timely delivery. The evidence is particularly relevant to first-trimester counselling because the preventive opportunity is time-limited.
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