Key result
Initiating low-dose aspirin before 12 weeks linked to ~71% lower preeclampsia risk vs 12-20 weeks.
Why the study?
Most clinical guidelines recommend low-dose aspirin initiation at 12 weeks of gestation because evidence supporting earlier use to reduce preeclampsia risk remains limited.
Does early initiation of low-dose aspirin before 12 weeks reduce adverse pregnancy outcomes in women with moderate-risk factors for preeclampsia?
Population
Women with singleton pregnancies delivered at ≥20 weeks and at least two moderate-risk factors for preeclampsia
Comparison
Aspirin initiation before 12 weeks vs between 12 and 20 weeks
Design
Single-center retrospective cohort study
Authors
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Supports earlier aspirin in moderate-risk preeclampsia; hypothesis-generating and requires RCTs before practice change.
Cohort (n=2,275)
No
Does early initiation of low-dose aspirin before 12 weeks reduce adverse pregnancy outcomes in women with moderate-risk factors for preeclampsia?
Odds Ratio: 0.29 (95% CI 0.2–0.42)
Absolute Event Rate: 4.2% vs 15.6%
Initiating low-dose aspirin before 12 weeks of gestation in women with moderate risk factors significantly reduces the risk of preeclampsia and other adverse pregnancy outcomes compared to standard initiation at 12-20 weeks.
Lee et al. (2026) conducted a cohort in Moderate-risk factors for preeclampsia (n=2,275). Early initiation of low-dose aspirin before 12 weeks vs. Late initiation between 12 and 20 weeks was evaluated on Preeclampsia (aOR 0.29, 95% CI 0.20-0.42). Early initiation of low-dose aspirin before 12 weeks was associated with a lower risk of preeclampsia compared to initiation between 12 and 20 weeks (4.2% vs 15.6%; aOR 0.29; 95% CI 0.20-0.42).
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