Today we are diving into a topic that is incredibly close to my heart—one that has the potential to fundamentally change how we approach prenatal care and protect pregnant patients. We’re talking about low-dose aspirin for the prevention of hypertensive disorders of pregnancy. Now, if you follow current formal guidelines, you probably know the standard protocol: 81 milligrams a day, prescribed based on specific risk factors. But there’s a growing body of evidence suggesting we might be underdosing—and under-prescribing. What if 162 milligrams taken universally across the board is actually far more effective?In today’s episode, we’re unpacking a brand-new, groundbreaking study published in the American Journal of Obstetrics & Gynecology. And I’m especially excited to cover this one because it comes straight out of my alma mater, Parkland Hospital! This study takes a bold look at real-world outcomes by comparing a period of universal 162-milligram aspirin use directly against a historical period when aspirin wasn’t recommended at all. Did a higher, universal dose significantly cut down on hypertensive disorders? And just as importantly …were there any adverse safety events we need to be aware of? Grab your coffee, settle in, and let's get into the details.
1. Duryea E, Ambia A, Pruszynski J. et al. Universal Aspirin Dispensation for Prevention of Preeclampsia in a High-Risk Population. AJOG, 2026; ePub 8/27/28
2. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013 Nov;122(5):1122-1131.
3. ACOG Issues Updated Hypertension Guidance, Discusses New ACC/AHA Criteria (2018): https://www.acog.org/news/news-releases/2018/12/acog-issues-updated-hypertension-guidance
4. Low-Dose Aspirin Use During Pregnancy, ACOG Committee Opinion Number 743 (2018)
5. Low-Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality. ACOG Practice Advisory; December 2021