NICE urges aspirin to reduce hypertension risks in pregnancy

26 August 2010

Pregnant women at high risk of developing hypertensive disorders in pregnancy should be encouraged to take small doses of aspirin to help prevent complications, according to newly published NICE guidelines.

The new guidance recommends that a low dose (75mg) aspirin should be offered daily to women at high risk of developing hypertension in pregnancy, such as those with chronic kidney disease, autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome, diabetes or chronic hypertension. Women who have had hypertensive disease during a previous pregnancy are also at high risk of pre-eclampsia.

Hypertension during pregnancy, including pre-eclampsia, is one of the leading causes of maternal death in the UK. Babies born to women who experience hypertension during pregnancy are also more likely to be premature, stillborn or smaller than average, while the mothers face an increased risk of developing high blood pressure later in life.

The guidance also recommends that women should be advised that restricting salt intake and taking dietary supplements such as magnesium or antioxidants (Vitamins C and E) will not help to prevent hypertension during pregnancy. Before pregnancy, GPs should inform women who take angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) that these drugs can increase the risk of congenital abnormalities if taken during pregnancy, and discuss taking other antihypertensive drugs. Women should stop taking ACE inhibitors or ARBs if they become pregnant and should be offered alternative treatments.

Stephen Walkinshaw, a consultant in maternal and foetal medicine at Liverpool Women's Hospital who chaired the development group for this guideline, said that the NICE guidance would "set out a clear pathway of care to guarantee that women are looked after in the best way possible no matter where they live."

"It will also ensure mums-to-be are given clear information by their doctor or midwife about their risks of developing such a condition and what is and is not effective in preventing these from occurring. It is important that both women and NHS staff have the knowledge to make informed decisions about care and treatment to ensure the best outcome for mother and child."

Link: Hypertension in pregnancy