Is Aspirin Safe During Pregnancy

Reason

Low-dose aspirin may be used in pregnancy only when prescribed; regular/high-dose aspirin needs provider review, especially after 20 weeks.

Drug Information

Brand Name

Aspirin

Generic Name

aspirin

Drug Class

NSAID; salicylate

FDA Category

N/A (PLLR narrative label)

Rx Status

OTC

Safe Amount

Dosage must be determined by your provider based on individual risk/benefit. Low-dose 81 mg aspirin may be used only when prescribed for certain pregnancy conditions.

Effects

Pregnancy

FDA warns against NSAIDs at 20 weeks or later unless needed. Low-dose 81 mg aspirin for certain pregnancy conditions is excepted under clinician care.

Mother

May increase bleeding risk. Use only as directed by a clinician in pregnancy.

Baby

Regular/high-dose NSAIDs can reduce fetal kidney function and amniotic fluid after 20 weeks; later use may affect the ductus arteriosus. Low-dose 81 mg aspirin is an official exception when prescribed.

Trimester Notes

1st Trimester

Low-dose aspirin may be prescribed for certain pregnancy conditions by a clinician. Do not start it on your own.

2nd Trimester

FDA warns against NSAIDs at 20 weeks or later unless your clinician says it is needed. Low-dose 81 mg aspirin is an official exception for some pregnancy conditions.

3rd Trimester

Avoid regular/high-dose aspirin unless your clinician specifically directs it. Late pregnancy NSAID use can affect the baby’s heart and circulation.

Risk-Benefit Note

Low-dose aspirin is sometimes used to help prevent preeclampsia in people at high risk, but it should be used only under clinician direction.

Conditions & Warnings

• Consult OB/GYN or prescriber
• Pregnancy dosing limits may apply
• Regular/high-dose aspirin after 20 weeks needs provider review

Alternatives

• Acetaminophen may be preferred for pain or fever in pregnancy, if your clinician says it is appropriate.
• Ask your OB/GYN or prescriber before using any pain reliever in pregnancy.

References

• FDA: Avoid Use of NSAIDs in Pregnancy at 20 Weeks or Later
  https://www.fda.gov/safety/medical-product-safety-information/nonsteroidal-anti-inflammatory-drugs-nsaids-drug-safety-communication-avoid-use-nsaids-pregnancy-20
• FDA: Recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later
  https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic
• ACOG: Low-Dose Aspirin Use During Pregnancy
  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy
• MotherToBaby/NCBI: Low Dose Aspirin
  https://www.ncbi.nlm.nih.gov/books/NBK582805/