Low-dose aspirin (LDA) is known to be effective in improving blood flow in several clinical settings, including prophylaxis of arterial thrombosis. It has been used without significant complication in multiple large randomized clinical trials in thousands of pregnant women.
A systematic review that included 39 trials involving over 30,000 women treated during pregnancy with aspirin compared with placebo or no treatment found that LDA was associated with a risk reduction for the development of severe preeclampsia (Duley et al, 2001).
An analysis of 10 trials including 627 women that evaluated interventions to improve pregnancy outcome in women with antiphospholipid antibodies, found neither toxicity nor serious negative maternal, fetal, or infant side effects from the use of LDA prior to conception or during pregnancy (Empson et al. 2002).
A recent analysis of 38 studies and over 25,000 women to assess the effects and safety of aspirin treatment during pregnancy on fetal and neonatal outcomes, did not find any negative fetal or infant side effects or toxicity for fetuses or infants from LDA treatment during high-risk pregnancies. (Kozer et al.,2003).
• Moreover, LDA is routinely used by clinicians with the intent of improving outcomes in women undergoing assisted reproductive technology and for those with recurrent pregnancy loss. There have been no reports of suspected toxicity or serious side effects of LDA based on this practice.
Folic acid in pregnancy
All participants in this study will be provided a folic acid supplement to take daily. Folic acid is a naturally occurring B vitamin that helps prevent birth defects of the brain and spinal cord, such as spina bifida, when taken before pregnancy and during the early stages of pregnancy. Although all women who are pregnant or trying to conceive should take a folic acid supplement, you can also get additional folic acid through your diet. Foods high in folate, the natural form of the vitamin, include fortified breakfast cereals, enriched breads and pasta, dried beans, leafy green vegetables and orange juice.
Side effects to folic acid are very rare, but may include allergic reactions, rash, itchy skin, difficulty breathing, or a darkening of your urine. Notify your doctor and study staff if any of these side effects occur.
