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Low-dose aspirin to prevent pre-eclampsia

A small daily dose of aspirin taken during pregnancy by women at higher risk of pre-eclampsia, to help prevent it. In England, NICE tells clinicians to advise 75 mg to 150 mg a day, from 12 weeks of pregnancy until the birth, for women at high risk and for women with more than one moderate risk factor. NICE notes that for this use aspirin has to be prescribed, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine. WHO gives different advice: 75 mg a day for women at moderate or high risk, using its own lists of risk factors.

  • Intervention
  • In this atlas

Overview

Technical summary

Aspirin (acetylsalicylic acid) at 75 mg to 150 mg daily from week 12 of pregnancy to the birth, as in NICE NG133 recommendations 1.1.2 and 1.1.3, both marked [2010, amended 2019]. The NICE page notes that at publication in June 2019 aspirin had no UK marketing authorisation, and says that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and that aspirin for this use must be prescribed. A recommendation is not an authorization. WHO 2021 recommends 75 mg per day for women at moderate or high risk and says treatment should start by 20 weeks or as soon as antenatal care starts (WHO labels this a "Context-specific recommendation"). The risk lists, doses and start times differ between issuers, so each is kept in its own claim and context. NICE NG133 gives no effect size; this record does not state one.

About this intervention

Type
Medicine
Mechanism
Not reported

Claims and evidence

Context Pregnant women at high risk of pre-eclampsia (NICE NG133 recommendation 1.1.2)

Recipient
Maternal
Population
Pregnant women at high risk of pre-eclampsia, which NICE defines as having any one of five listed factors.
Care setting
Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
Geography
England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
Life stage
Pregnancy, from 12 weeks until the baby is born
Gestational age
at least 12 weeks 0 days (84 days)
Postnatal age
Not reported
Follow-up
Not applicable (recommendation context)
Eligibility: 5 inclusion criteria; 1 exclusion criterion
Included
  • Hypertensive disease during a previous pregnancy
  • Chronic kidney disease
  • Autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome
  • Type 1 or type 2 diabetes
  • Chronic hypertension
Excluded
  • Not stated in the recommendation text

  • Recommendation Guidance Certainty not assessed

    NICE tells clinicians to advise women who are pregnant and at high risk of pre-eclampsia to take aspirin every day at a dose of 75 mg to 150 mg, from 12 weeks of pregnancy until the baby is born. High risk means having any one of five listed factors: hypertensive disease in a previous pregnancy, chronic kidney disease, autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome, type 1 or type 2 diabetes, or chronic hypertension.

    Applies to Maternal
    • Pregnant women at high risk of pre-eclampsia, which NICE defines as having any one of five listed factors.
    • Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
    • England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
    • Pregnancy, from 12 weeks until the baby is born
    • Gestational age at least 12 weeks 0 days
    • Postnatal age Not reported
    Follow-up Not applicable (recommendation context)
    Certainty method
    Not assessed
    Limitations
    This is a guideline recommendation, not a marketing authorisation. The NICE page says that at publication in June 2019 aspirin had no UK marketing authorisation for this use, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and also that aspirin for this use must be prescribed. The page gives no strength grade, no certainty rating and no effect size for this advice, so none is recorded. The dose range, the start time and the risk list are NICE's. WHO 2021 recommends 75 mg per day for women at moderate or high risk, with different risk lists, and says to start by 20 weeks or as soon as antenatal care starts (WHO labels this a "Context-specific recommendation"), so the advice differs between issuers. Do not apply this claim outside the NICE context.
    Last checked
    2026-10-12
    Next evidence check due
    Not scheduled
    Sources and citations (6)

    1. Supports Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      1.1.2, first sentence and lead-in to the list
      How it applies
      NICE NG133, cited and linked only. The dose, the start time and the end point.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    2. Supports Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      1.1.2, high-risk list and recommendation tag
      How it applies
      The five factors that define high risk, and the tag [2010, amended 2019].
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    3. Background Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      Antiplatelet agents, note before 1.1.2
      How it applies
      Marketing authorisation status in the UK at June 2019, and the need for a prescription.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    4. Background Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Update information chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The Update information chapter of NICE guideline NG133, as shown on 2026-10-11 with the page header Last updated: 17 April 2023. It lists what changed in June 2019, the minor changes after publication (August 2022, April 2023 and October 2023) and the guideline ISBN. The chapter has no identifier of its own because the Recommendations chapter source already holds the identifier NG133. Cluster B and cluster C fetched this page separately on 2026-10-11 and both returned the same bytes (sha256 248348547ec88c3384b6fb76489a433766acf40e47b5f77d8060516561836a58). The integration step kept this one source and snapshot and redirected the cluster C citations to them. · Published 2019-06-25

      Locator
      June 2019 update, changes made without an evidence review
      How it applies
      NICE says it amended the aspirin dose information in June 2019 without an evidence review.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      248348547ec88c3384b6fb76489a433766acf40e47b5f77d8060516561836a58
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11 and recorded in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    5. Background WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

      Guideline · World Health Organization · Edition 2021, electronic edition. The PDF (81 pages) came from WHO IRIS handle 10665/350190 through the IRIS REST API content endpoint (bitstream 76d9febc-540a-4a2e-8664-237f523a3e47), because the older apps.who.int links no longer return the PDF. The who.int publication page supplied the date. · Published 2021-12-06 · isbn: 978-92-4-003754-0

      Locator
      Table 1, recommendation
      How it applies
      WHO 2021, a different issuer with a different dose and risk lists. Shown to mark that issuers differ, not to support the NICE advice.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      98c96df70c4a3ad168f56ffcea73cd3cba2626474ff0e541412f7c81704eadd3
      Reuse basis
      Licensed CC BY-NC-SA 3.0 IGO, as stated in the PDF. Only short quotations with attribution are used, and the PDF is not committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.

    6. Background WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

      Guideline · World Health Organization · Edition 2021, electronic edition. The PDF (81 pages) came from WHO IRIS handle 10665/350190 through the IRIS REST API content endpoint (bitstream 76d9febc-540a-4a2e-8664-237f523a3e47), because the older apps.who.int links no longer return the PDF. The who.int publication page supplied the date. · Published 2021-12-06 · isbn: 978-92-4-003754-0

      Locator
      Table 2, recommendation
      How it applies
      WHO 2021 start time, which differs from the NICE start time.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      98c96df70c4a3ad168f56ffcea73cd3cba2626474ff0e541412f7c81704eadd3
      Reuse basis
      Licensed CC BY-NC-SA 3.0 IGO, as stated in the PDF. Only short quotations with attribution are used, and the PDF is not committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.

Context Pregnant women with more than one moderate risk factor for pre-eclampsia (NICE NG133 recommendation 1.1.3)

Recipient
Maternal
Population
Pregnant women who have more than one of six moderate risk factors for pre-eclampsia that NICE lists.
Care setting
Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
Geography
England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
Life stage
Pregnancy, from 12 weeks until the baby is born
Gestational age
at least 12 weeks 0 days (84 days)
Postnatal age
Not reported
Follow-up
Not applicable (recommendation context)
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • More than one of the following moderate risk factors: nulliparity; age 40 years or older; pregnancy interval of more than 10 years; body mass index of 35 kg/m2 or more at the first visit; family history of pre-eclampsia; multi-fetal pregnancy
Excluded
  • Not stated in the recommendation text

  • Recommendation Guidance Certainty not assessed

    NICE tells clinicians to advise women who are pregnant and have more than one moderate risk factor for pre-eclampsia to take aspirin every day at a dose of 75 mg to 150 mg, from 12 weeks of pregnancy until the baby is born. The six moderate risk factors are nulliparity, age 40 years or older, a pregnancy interval of more than 10 years, a body mass index of 35 kg/m2 or more at the first visit, a family history of pre-eclampsia and a multi-fetal pregnancy.

    Applies to Maternal
    • Pregnant women who have more than one of six moderate risk factors for pre-eclampsia that NICE lists.
    • Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
    • England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
    • Pregnancy, from 12 weeks until the baby is born
    • Gestational age at least 12 weeks 0 days
    • Postnatal age Not reported
    Follow-up Not applicable (recommendation context)
    Certainty method
    Not assessed
    Limitations
    This is a guideline recommendation, not a marketing authorisation. The NICE page says that at publication in June 2019 aspirin had no UK marketing authorisation for this use, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and also that aspirin for this use must be prescribed. The page gives no strength grade, no certainty rating and no effect size, so none is recorded. A single moderate factor does not meet the NICE advice; the advice needs more than one. WHO 2021 recommends 75 mg per day for women at moderate or high risk and defines moderate risk as any two of its own list, which includes primiparity rather than nulliparity, so the issuers differ in dose, risk list and start time. Do not apply this claim outside the NICE context.
    Last checked
    2026-10-12
    Next evidence check due
    Not scheduled
    Sources and citations (8)

    1. Supports Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      1.1.3, first sentence and lead-in to the list
      How it applies
      NICE NG133, cited and linked only. The dose, the start time and the number of factors needed.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    2. Supports Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      1.1.3, moderate-risk list, items 1 to 3
      How it applies
      The first three of the six moderate risk factors, beginning with nulliparity.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    3. Supports Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      1.1.3, moderate-risk list, items 4 to 6 and recommendation tag
      How it applies
      The last three moderate risk factors, and the tag [2010, amended 2019].
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    4. Background Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later. · Published 2019-06-25 · nice: NG133

      Locator
      Antiplatelet agents, note before 1.1.2
      How it applies
      Marketing authorisation status in the UK at June 2019, and the need for a prescription.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      0cd8548f5807f03a82b3101dc56ebadf674106da9d0aa7e57955d4a823556fca
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    5. Background Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Update information chapter

      Guideline · National Institute for Health and Care Excellence (NICE) · Edition The Update information chapter of NICE guideline NG133, as shown on 2026-10-11 with the page header Last updated: 17 April 2023. It lists what changed in June 2019, the minor changes after publication (August 2022, April 2023 and October 2023) and the guideline ISBN. The chapter has no identifier of its own because the Recommendations chapter source already holds the identifier NG133. Cluster B and cluster C fetched this page separately on 2026-10-11 and both returned the same bytes (sha256 248348547ec88c3384b6fb76489a433766acf40e47b5f77d8060516561836a58). The integration step kept this one source and snapshot and redirected the cluster C citations to them. · Published 2019-06-25

      Locator
      June 2019 update, changes made without an evidence review
      How it applies
      NICE says it amended the aspirin dose information in June 2019 without an evidence review.
      Retrieved
      Source effective date
      2023-04-17
      Source state
      Current
      Snapshot hash
      248348547ec88c3384b6fb76489a433766acf40e47b5f77d8060516561836a58
      Reuse basis
      The page bytes are not committed. Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE reuse terms, read on 2026-10-11 and recorded in research/setup/notes.md: the NICE UK Open Content Licence covers use in a UK setting only, international use outside personal research and study needs a licence and a fee, and the NICE terms and conditions make content available for artificial intelligence purposes only through an approval process, a licence and a fee for international use. This pipeline uses AI agents to read the page, so Ben decided on 2026-10-13 that public pages cite and link NICE and use none of its wording.

    6. Background WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

      Guideline · World Health Organization · Edition 2021, electronic edition. The PDF (81 pages) came from WHO IRIS handle 10665/350190 through the IRIS REST API content endpoint (bitstream 76d9febc-540a-4a2e-8664-237f523a3e47), because the older apps.who.int links no longer return the PDF. The who.int publication page supplied the date. · Published 2021-12-06 · isbn: 978-92-4-003754-0

      Locator
      Table 1, recommendation
      How it applies
      WHO 2021, a different issuer with a different dose. Shown to mark that issuers differ.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      98c96df70c4a3ad168f56ffcea73cd3cba2626474ff0e541412f7c81704eadd3
      Reuse basis
      Licensed CC BY-NC-SA 3.0 IGO, as stated in the PDF. Only short quotations with attribution are used, and the PDF is not committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.

    7. Background WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

      Guideline · World Health Organization · Edition 2021, electronic edition. The PDF (81 pages) came from WHO IRIS handle 10665/350190 through the IRIS REST API content endpoint (bitstream 76d9febc-540a-4a2e-8664-237f523a3e47), because the older apps.who.int links no longer return the PDF. The who.int publication page supplied the date. · Published 2021-12-06 · isbn: 978-92-4-003754-0

      Locator
      Table 1, remarks, bullet 2
      How it applies
      WHO's moderate-risk rule: any two of a list that names primiparity.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      98c96df70c4a3ad168f56ffcea73cd3cba2626474ff0e541412f7c81704eadd3
      Reuse basis
      Licensed CC BY-NC-SA 3.0 IGO, as stated in the PDF. Only short quotations with attribution are used, and the PDF is not committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.

    8. Background WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

      Guideline · World Health Organization · Edition 2021, electronic edition. The PDF (81 pages) came from WHO IRIS handle 10665/350190 through the IRIS REST API content endpoint (bitstream 76d9febc-540a-4a2e-8664-237f523a3e47), because the older apps.who.int links no longer return the PDF. The who.int publication page supplied the date. · Published 2021-12-06 · isbn: 978-92-4-003754-0

      Locator
      Table 2, recommendation
      How it applies
      WHO 2021 start time, which differs from the NICE start time.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      98c96df70c4a3ad168f56ffcea73cd3cba2626474ff0e541412f7c81704eadd3
      Reuse basis
      Licensed CC BY-NC-SA 3.0 IGO, as stated in the PDF. Only short quotations with attribution are used, and the PDF is not committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.

Guidance

Recommended: Low-dose aspirin to prevent pre-eclampsia

Applies to Maternal
  • Pregnant women at high risk of pre-eclampsia, which NICE defines as having any one of five listed factors.
  • Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
  • England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
  • Pregnancy, from 12 weeks until the baby is born
  • Gestational age at least 12 weeks 0 days
  • Postnatal age Not reported
Follow-up Not applicable (recommendation context)
Issued by
National Institute for Health and Care Excellence (NICE)
Guideline
Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter, edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later.
Strength
Advise (no graded strength label on the page) (NICE guideline wording, in which the verb shows the strength of a recommendation. The page points to a separate NICE document that explains how, and gives no GRADE rating for this recommendation.)
Effective
2019-06-25 (The recommendation is tagged [2010, amended 2019]. 25 June 2019 is the guideline's publication date, which is when the 2019 amendments were made. The page was last updated on 17 April 2023 for other recommendations.)
Jurisdiction
England. NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
Supersession
Not checked
Basis
NICE tells clinicians to advise women who are pregnant and at high risk of pre-eclampsia to take aspirin every day at a dose of 75 mg to 150 mg, from 12 weeks of pregnancy until the baby is born. High risk means having any one of five listed factors: hypertensive disease in a previous pregnancy, chronic kidney disease, autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome, type 1 or type 2 diabetes, or chronic hypertension.

Limitations. This is a guideline recommendation, not a marketing authorisation. The NICE page says that at publication in June 2019 aspirin had no UK marketing authorisation for this use, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and also that aspirin for this use must be prescribed. The page gives no strength grade, no certainty rating and no effect size for this advice, so none is recorded. The dose range, the start time and the risk list are NICE's. WHO 2021 recommends 75 mg per day for women at moderate or high risk, with different risk lists, and says to start by 20 weeks or as soon as antenatal care starts (WHO labels this a "Context-specific recommendation"), so the advice differs between issuers. Do not apply this claim outside the NICE context.

Recommended: Low-dose aspirin to prevent pre-eclampsia

Applies to Maternal
  • Pregnant women who have more than one of six moderate risk factors for pre-eclampsia that NICE lists.
  • Not stated in the source beyond two notes: community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and aspirin for this use must be prescribed.
  • England. NICE's terms and conditions present the information on its websites as support for people in England (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
  • Pregnancy, from 12 weeks until the baby is born
  • Gestational age at least 12 weeks 0 days
  • Postnatal age Not reported
Follow-up Not applicable (recommendation context)
Issued by
National Institute for Health and Care Excellence (NICE)
Guideline
Hypertension in pregnancy: diagnosis and management (NICE guideline NG133), Recommendations chapter, edition The version shown on 2026-10-11, with a page header that gives 17 April 2023 as the last update. The same bytes came back on a second fetch minutes later.
Strength
Advise (no graded strength label on the page) (NICE guideline wording, in which the verb shows the strength of a recommendation. The page points to a separate NICE document that explains how, and gives no GRADE rating for this recommendation.)
Effective
2019-06-25 (The recommendation is tagged [2010, amended 2019]. 25 June 2019 is the guideline's publication date, which is when the 2019 amendments were made. The page was last updated on 17 April 2023 for other recommendations. Wording corrected in August 2022 (first pregnancy to nulliparity); the effective date stays 2019-06-25.)
Jurisdiction
England. NICE's terms and conditions present the information on its websites as support for people in England who make decisions about funding care (clause 6) and say it is not written as a basis for decisions outside the United Kingdom (clause 8). The guideline page states no jurisdiction of its own.
Supersession
Not checked
Basis
NICE tells clinicians to advise women who are pregnant and have more than one moderate risk factor for pre-eclampsia to take aspirin every day at a dose of 75 mg to 150 mg, from 12 weeks of pregnancy until the baby is born. The six moderate risk factors are nulliparity, age 40 years or older, a pregnancy interval of more than 10 years, a body mass index of 35 kg/m2 or more at the first visit, a family history of pre-eclampsia and a multi-fetal pregnancy.

Limitations. This is a guideline recommendation, not a marketing authorisation. The NICE page says that at publication in June 2019 aspirin had no UK marketing authorisation for this use, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine, and also that aspirin for this use must be prescribed. The page gives no strength grade, no certainty rating and no effect size, so none is recorded. A single moderate factor does not meet the NICE advice; the advice needs more than one. WHO 2021 recommends 75 mg per day for women at moderate or high risk and defines moderate risk as any two of its own list, which includes primiparity rather than nulliparity, so the issuers differ in dose, risk list and start time. Do not apply this claim outside the NICE context.

Clinical links

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Record details

Record id
maternal:low-dose-aspirin-preeclampsia-prevention
Content hash
6c5027ade91c223ec29d8f9165c094ae3be1c354fe5c39c2c6157041546f0751