Why Baby Aspirin (But Not Regular Aspirin) is Safe in Pregnancy – Key Insights

Pregnancy is a time when expectant mothers are often particularly cautious about what they put into their bodies. This includes medications, both over-the-counter and prescribed. One question many women may have is why some medications that are typically considered safe in general use—such as aspirin—are not recommended during pregnancy, while a specific type, baby aspirin, is deemed safe in certain situations. In this article, we will delve into why baby aspirin is sometimes prescribed during pregnancy, why it differs from regular aspirin, and the role of antenatal care in ensuring the health of both mother and baby. Understanding the nuances of medication during pregnancy is crucial, as it directly impacts both the expectant mother’s health and the development of the baby. Antenatal appointments provide valuable opportunities for healthcare providers to offer guidance on safe medication use and discuss alternatives when necessary. In this detailed guide, we will explore how antenatal care professionals monitor and manage the use of medications like baby aspirin throughout pregnancy. What is Baby Aspirin? Baby aspirin is a low-dose version of regular aspirin. Typically, it contains 75 to 100 milligrams of acetylsalicylic acid, compared to the 325 milligrams found in a standard aspirin tablet. The reduced dosage makes baby aspirin less likely to cause side effects, particularly in relation to the stomach and bleeding risks, which is one of the primary concerns when taking regular aspirin during pregnancy. How Does Baby Aspirin Differ From Regular Aspirin? While both baby aspirin and regular aspirin work in similar ways by reducing inflammation, pain, and fever, their impact on the body differs in important ways. The most notable differences include:

1. Dosage: The most significant difference between baby aspirin and regular aspirin is the dosage. Baby aspirin is a low-dose medication designed to have a minimal impact on the body, while regular aspirin is used in higher doses for pain relief and inflammation management.
2. Effect on Platelet Function: Aspirin works by inhibiting the function of platelets, which are responsible for blood clotting. While this effect is beneficial in treating conditions like cardiovascular disease or arthritis, excessive inhibition can be harmful, especially during pregnancy. Regular aspirin at higher doses may increase the risk of bleeding complications, such as post-partum haemorrhage. Baby aspirin, with its lower dosage, has a much milder effect on platelet function and is deemed safer for use during pregnancy when indicated by a healthcare provider.
3. Use in Pregnancy: While regular aspirin is generally advised against during pregnancy, baby aspirin is often prescribed in specific circumstances, such as for women at risk of preeclampsia, a condition marked by high blood pressure and damage to organs such as the kidneys. Antenatal care professionals monitor the effects of baby aspirin closely to ensure that it supports maternal and fetal health without causing undue harm. Why Baby Aspirin is Prescribed During Pregnancy In certain cases, baby aspirin may be prescribed during pregnancy for its potential benefits. These include:
4. Preventing Preeclampsia: One of the most common uses for baby aspirin during pregnancy is the prevention of preeclampsia. This condition, which typically develops after 20 weeks of pregnancy, is characterised by high blood pressure and protein in the urine. Left untreated, preeclampsia can lead to severe complications for both mother and baby, including organ failure, preterm birth, and stillbirth. Studies have shown that taking low-dose aspirin, especially in high-risk pregnancies, can reduce the risk of developing preeclampsia. Antenatal care providers typically recommend baby aspirin for women who have a history of preeclampsia, are carrying multiples, or have certain health conditions that increase their risk, such as chronic hypertension or diabetes.
5. Improving Placental Blood Flow: Baby aspirin can help improve blood flow to the placenta, which may benefit fetal growth and development. In particular, it can be helpful for women who are at risk for placental insufficiency, a condition in which the placenta does not provide enough nutrients and oxygen to the developing baby.
6. Reducing the Risk of Miscarriage: In some cases, baby aspirin may be used as part of a broader treatment plan for women who have experienced recurrent miscarriages. The theory behind this use is that baby aspirin may help prevent clotting issues that could interfere with pregnancy. However, more research is needed in this area to fully establish the effectiveness and safety of baby aspirin for miscarriage prevention.
7. Reducing Blood Clotting Risks: Certain conditions, such as antiphospholipid syndrome or a history of deep vein thrombosis (DVT), increase the risk of blood clots during pregnancy. For women with these conditions, baby aspirin may be prescribed to reduce the likelihood of clotting and improve overall circulation during pregnancy. Again, antenatal care professionals carefully monitor the effects of this medication to ensure the health of both mother and baby. Why Regular Aspirin is Not Recommended During Pregnancy While baby aspirin has its uses in specific antenatal circumstances, regular aspirin is generally not recommended during pregnancy. The reasons for this include:
8. Risk of Bleeding: Regular aspirin can increase the risk of bleeding during pregnancy, especially in the later stages. This is a particular concern during labour and delivery, as it could lead to complications such as postpartum haemorrhage (excessive bleeding after birth). The use of regular aspirin can also interfere with blood clotting in the baby, increasing the risk of bleeding disorders.
9. Impact on the Baby’s Organ Development: Regular aspirin, particularly when taken during the later stages of pregnancy, has been associated with potential harm to the developing baby. It may interfere with the baby’s ability to produce important chemicals that help regulate blood flow in the lungs, leading to complications such as pulmonary hypertension. Additionally, regular aspirin use in the third trimester can increase the risk of premature closure of the ductus arteriosus, a blood vessel in the baby’s heart that is crucial for proper circulation before birth.
10. Potential for Kidney Damage: Regular aspirin can also affect kidney function, both in the mother and in the developing baby. This is particularly concerning during pregnancy, when both the mother’s and baby’s kidneys are working under increased strain. The Role of Antenatal Care in Managing Medication Use Managing medication use during pregnancy is a vital part of antenatal care. Healthcare professionals, including obstetricians and midwives, play a critical role in monitoring the safety of any medication prescribed during pregnancy. Regular antenatal appointments are essential to ensure that any prescribed medication, including baby aspirin, is not having unintended effects on the mother or baby. Antenatal care involves:

• Monitoring Maternal and Fetal Health: Regular check-ups allow healthcare providers to monitor blood pressure, protein levels, and overall health. This is essential when taking medications such as baby aspirin, as it can help prevent any adverse effects from developing.
• Educating the Expectant Mother: Expectant mothers are provided with information about the safety and risks of medications, including baby aspirin. This includes the timing of when it should be taken and the appropriate dosage. Healthcare professionals also educate patients on other ways to maintain a healthy pregnancy, such as maintaining a balanced diet, staying active with antenatal yoga, and attending antenatal classes to learn more about the pregnancy process.
• Adjusting Medications as Needed: If a woman’s condition changes, antenatal care providers may adjust her medication regimen. For example, if she develops high blood pressure, she may be prescribed baby aspirin to reduce the risk of preeclampsia or complications related to placental insufficiency. While regular aspirin is not recommended during pregnancy due to potential risks such as bleeding, kidney damage, and complications with the baby’s organ development, baby aspirin is a safer alternative in specific cases when prescribed by a healthcare provider. Baby aspirin is often used to reduce the risk of preeclampsia, improve placental blood flow, and manage conditions that could affect pregnancy, such as antiphospholipid syndrome. Ultimately, the decision to use any medication during pregnancy should be made in consultation with a healthcare professional, as they can provide personalised guidance based on the unique needs of the mother and baby. Attending regular antenatal checkups and discussing any concerns with your healthcare provider will help ensure that both mother and baby remain healthy and that the use of medications like baby aspirin is managed appropriately.