Aspirin shows promise in preventing miscarriages

UDEA/DICYT All parents want to have an uncomplicated pregnancy resulting in completely healthy babies, however some pregnancies may end in a miscarriage, which sometimes can occur repetitively (recurrent miscarriages). Also pregnancies may be affected by complications occurring at certain stages of pregnancy. These complications include unintentional expulsion of the fetus, stillbirth and preeclampsia.

Recurrent pregnancy loss (RPL), or repeated failed pregnancies, is a medical condition faced by many couples. The Recurrent Pregnancy Loss Program at the University of Antioquia provides guidance and support to couples with RPL in order to help them navigate through the work-up and treatment of this disorder.

After a medical evaluation for possible causes of RPL, a blood sample is taken from the mother in order to check for specific antibodies (antiphospholipid antibodies) that are responsible for pregnancy complications. These antibodies are usually associated with the antiphospholipid syndrome, a disorder that manifests clinically as recurrent venous or arterial thrombosis and/or fetal loss.

New hope on miscarriages

Aspirin and heparin are the most commonly used drugs to prevent antiphospholipid syndrome during the early pregnancy stages. Aspirin or acetylsalicylic acid which was developed originally 115 years ago is one of the most widely used medications worldwide.

Despite controversy, experts recommend a daily low-dose aspirin (100 mg), or a pill of baby aspirin, to help reduce the risk of preeclampsia in high-risk women. Studies suggest that administration of low-dose aspirin at or before the 16th week of pregnancy can significantly reduce the risk of pregnancy complications. However there has been controversy regarding the benefits of aspirin use since some studies have not shown much benefit of aspirin ingestion.

A recent study by UA researchers found that women who have had previous miscarriages and took low dose aspirin during their next pregnancy – regardless of whether they were taking progesterone – had a reduced risk of miscarriage.

These findings have encouraged researchers to conduct further research on how low dose aspirin intake may help prevent pregnancy loss. These studies aim to promote safer and rational use of aspirin, select those patients who are most likely to benefit from the drug, and determine when to start treatment as well as the recommended dosage. It should also be noted that aspirin is one of the most widely used treatments for pregnancy complications because of its relative safeness and low cost.

Low-dose aspirin use is very common among the elderly, and is also one of the most cost-effective treatment options for secondary prevention of cardiovascular conditions such as stroke and heart attack. However, there is insufficient evidence about the benefits of aspirin in healthy adults.

Aspirin inhibits the formation of substances that cause inflammation and blood clots. Researchers recently found that aspirin helps trigger the production of epi-lipoxins and resolvins which are molecules naturally produced by the body and play an important role in controlling inflammation.

UA researchers are studying the potential effect of aspirin and epi-loxins in reproductive disorders. Researchers use placental cells and serum samples taken from women with a history of recurrent miscarriages (with and without antiphospholipid antibodies) to simulate complications that can occur in pregnancy in order to assess the effect of serum on placental cells and determine whether aspirin and heparin can help prevent these effects.

The study showed that antiphospholipid antibodies may affect placental cells functions, and low-dose aspirin and heparin can reverse these effects.

Although these results are promising, further research is needed to clarify how these drugs work in order to provide appropriate treatment protocols in preventing reproductive disorders involving immunological abnormalities.

Although low-dose aspirin is likely safe in pregnancy women with a history of miscarriages or preeclampsia should not take this medication without medical advice in order to prevent complications related to improper use of this drug