Risk factors for aspirin

[Gingernut1989]

I am pregnant with my third baby and just had a phone call to be told that because it has been over 10 years since my last pregnancy , my previous babies were apparently small for gestational age and my mum had pre eclampsia that I need to be taking aspirin daily.

I am 34 years old and 19 weeks pregnant. Blood pressure has always been fine at every check-up and I never had pre-eclampsia or pre-term births before. I am a healthy weight always have been. First born was 7lb 2oz 3 days early and second born was 6lb 12oz at 41 weeks. I asked how imperative this was and was told it is vitally important that I take it because I have moderate risk factors and I could have a still born if I do not.

Has anyone else had to take this when they themselves have never had pre eclampsia?

With my first pregnancy, yes. I had a few risk factors for pre-eclampsia, so took aspirin from 12 weeks until 36 weeks.

With my second pregnancy it was because I'd previously had pre-eclampsia.

I've had 2 completely normal pregnancies with no high blood pressure . They knew then that my mum had pre-eclampsia but now I'm being told i need it. I'm 19 weeks and again been absolutely fine blood pressure wise.

you have at least two 'moderate' risk factors (10 yr interval between pregnancies and family history). Their advice is standard. The guidelines are easily googleable.

This does not mention 10 year gap.

Taking aspirin to help prevent pre-eclampsia is a somewhat recent development. As you say, it's been over 10 years since your last baby, so it might not have been policy then. The advice changed between my two pregnancies to increase the dose from 75 to 150mg. Just from reading Mumsnet it seems like it's becoming very common to take on pregnancy should you have any risk factors at all.

I have a high BMI, currently 24 weeks with my first and since the beginning of my pregnancy I’ve been advised to take aspirin every night, so have been doing!

Pre-eclampsia | RCOG

You have 2 moderate risk factors; family history and a small baby in the past (not sure of sex of baby so can't calculate exact centile but on the lower side for 41 weeks). Aspirin is effective at preventing pre eclampsia and is a relatively low risk intervention. Not many reasons to not go for it if it lowers your risk of developing PET.
I took it until 36 weeks due to 2 moderate risk factors (strong family history and first pregnancy) and thankfully did not develop PET.
If you're still unsure after doing some reading, request another call with your team to go over your concerns.

I didn't see small baby or over 10 year gap as a moderate risk factor on the nhs link I'd found in another thread I did share the post but it was from an nhs hospital I think.

I guess I will do as I'm told then I just was unsure how imperative it was.

The RCOG link had the over 10 years risk.

What is causing you concern? I had to take it for both of my pregnancies.

I just wanted to know how necessary it was as I didn't take it in my 2 previous pregnancies. I'm not anti vax or a conspiracy theorist I just wanted to understand i guess. I'll just blindly take it though if there's no negative side effects to aspirin in pregnancy.

I think it’s a pretty well trodden path. My eldest is nearly 17 and it was common then. I had multiple MC and it’s almost the first step. I also took other blood thinners so I bled like a pig after delivery, but apart from that no issues.

Have you read any of the papers on the Royal Colleges, green tops, I think they are called (long time ago now).

OP. I don't have up to your age gap and no family history but based on all my kids being SGA, I've been recommended it. Just like you I was very adamant because I'm already taking several meds for nausea and vomiting but my sis who is an obgyn was like don't wait until 12 weeks, start taking it now. The reason they say wait until 12 weeks is to ensure it's not ectopic. Once that's cleared you're good to go. The benefit apparently outweighs the risk. My last pregnancy was twin pregnancy and was switched up from 75 to 150 during the pregnancy.

That's the same as me I'm already on 5 different meds for sickness plus my epilepsy medication. They have only just told me to start now at 19 weeks so hopefully that's not too late if there is a risk.

I was advised to take asprin in my first pregnancy. It was following my 12week scan where they identified that i had high pressure in one of my uterine arteries. I had no issues in that pregnancy except for high BP on the day I went into labour. Baby was born SGA though.

For DD2, despite all the above and being 3yrs older (37), I was not advised to take it. So I didn't and I did go on to develop preeclampsia. I personally wish I had just taken it anyway without being told to as having preeclampsia in pregnancy is now linked to increase risk of heart issues later in life, so it would have been good to avoid that. But obviously too late for that now.

I was on 19 different tablets a day at the point of giving birth to control my BP so you definitely don't want to end up like me!

The consultant who discharged me said that she thinks asprin in pregnancy will eventually become like folic acid - everyone will be advised to take a low dose and those with more risk factors will take a higher dose.

My LG is 1 year old now I was told to take Aspirin and never did. I told my midwife I done all my research and would not be forced into taking unneccesary medication just because I sit in a certain category. I had a perfect birth no issues whatsoever. Currently pregnant with my second and again when offered won't be taking it. Your Body Your Decision. I reccommend following The Naked Doula on instagram lots of helpful info reg any pregnancy related questions x

That's interesting if it becomes like folic acid. It doesn't make you birth huge babies does it like the opposite of having a small for gestational age ? Haha or is that just me thinking daft ?

People have def played Russian Roulette and survived, doesn’t make it a safe game.

I’ve seen people on instagram talking absolute nonsense. Consultants tend to be risk averse, but alao
at the top of their game in terms of preserving life.

Haha I think there would be lots of complaints if it did!

My "with asprin" baby was 5lbs12oz at 38w
My "without asprin / with preeclampsia" baby was 6lbs3oz at 39+3w

Definitely no huge babies in my case.

Imagining giant babies caused by aspirin now haha. I can't get it until next week so hopefully it'll be OK not too late.

It is a personal decision. Which was why I researched everything and weighed up pros & cons. As for consultants I won't get into that as would be here all day. All I say to anyone is do your own research. And yes I agree on some instagram accounts but there are good ones out there too which are helpful especially for first time Mums.

Look up NHS saving babies lives version 3. Element 3, fetal growth restriction. Appendix c. Clear information on who is advised to take it and why. Sadly babies that are growth restricted have higher mortality (stillbirth) rates. Aspirin not only helps prevent preeclampsia but basically also helps with the blood flow/health of the placenta which stops growth restriction. Your hospital should provide you with information. Please please don’t rely on Instagram accounts to get advice. Which I am sure you won’t.

My Dsid used to work in emergency gynae theatre. I think the tales of tragedy over the years have left me risk averse. The ‘baby will come when it’s ready’ being the worst of the top tips. I can see that they may be quite flippant on some fronts but it’s often driven by over exposure to the downside risks - I won’t spell out what that means as I’m sure you can work it out.

The problem is separating the "good" ones from the dangerous ones. I see so many insta accounts that talk about declining antibiotics in labour for example. I didn't know I was GBS+ with DD1 so i wasnt offered antibiotics, but she developed GBS sepsis and needed two weeks in NICU / SCBU. I wish i had been offered antibiotics! Something so traumatic that could have been prevented. I hate to think of other mums having to experience what I did because they read some dodgy insta influencer instead of the actual evidence.