New research presented at the Society for Maternal-Fetal Medicine (SMFM) 2025 meeting challenges the assumption that a higher aspirin dose provides better protection against preeclampsia in high-risk pregnancies. The ASAPP (Aspirin Study for Preeclampsia Prevention) study found that doubling the standard 81 mg daily dose to 162 mg did not significantly reduce the incidence of preterm preeclampsia or severe cases, reinforcing the effectiveness of the current recommended dosage.
Study Findings on Aspirin Dosage
Preeclampsia, a pregnancy-related hypertensive disorder, remains a leading cause of maternal and fetal complications worldwide. Low-dose aspirin (81 mg daily) is commonly recommended for high-risk individuals to reduce the likelihood of developing preeclampsia. However, the ASAPP study investigated whether increasing the dose to 162 mg daily would enhance protective effects.
Led by Dr. Amrin Khander from Weill Cornell Medicine/New York – Presbyterian Hospital, the study compared preeclampsia outcomes in pregnant women taking either 81 mg or 162 mg of aspirin. The researchers found no significant difference between the two groups in terms of preterm preeclampsia or preeclampsia with severe features. These results suggest that increasing the aspirin dose does not provide additional benefits in preventing the condition.
Implications for Clinical Practice
Aspirin for Preeclampsia Prevention: Higher Dose Shows No Added Benefit
The findings support current guidelines recommending low-dose aspirin (81 mg) as an effective preventive measure for preeclampsia in high-risk pregnancies. While some clinicians may have considered a higher dose to enhance protection, this study reinforces that doubling the dose does not improve outcomes.
Key takeaways for healthcare providers:
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81 mg of aspirin daily remains the recommended dose for preeclampsia prevention in high-risk pregnancies.
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Higher doses do not appear to offer added benefits and may increase the risk of side effects such as gastrointestinal bleeding.
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Ongoing monitoring and early detection of preeclampsia symptoms remain crucial for managing high-risk pregnancies.
Conclusion
The ASAPP study provides valuable insights into aspirin dosing for preeclampsia prevention, confirming that the standard 81 mg daily dose is sufficient for high-risk pregnancies. Future research may explore alternative strategies for further reducing preeclampsia risk, but for now, current guidelines remain supported by clinical evidence.
