News

4/8/14 The U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement on the use of low-dose aspirin for the prevention of morbidity and mortality from preeclampsia. The USPSTF recommends low-dose aspirin (81 mg/day) use after 12 weeks of pregnancy in women who are at high risk for preeclampsia. The USPSTF assigned a "B" rating to the recommendation, indicating that the Task Force recommends the service.

Preeclampsia is a complex condition that occurs in pregnant women and is characterized by an increase in blood pressure and excess protein in the urine after 20 weeks of pregnancy. According to the USPSTF, the condition is one of the leading causes of health complications for expectant mothers and their babies (if left untreated it can lead to both maternal and infant morbidity and mortality), affecting about 4% of all pregnancies in the United States, and as many as 8% of pregnancies worldwide. Preeclampsia also accounts for 15% of preterm births in the United States.

The Task Force's recommendation applies to pregnant women who are at high risk for preeclampsia and haven't had any health problems from using aspirin in the past. Risk factors include: preeclampsia, preterm birth or intrauterine growth restriction (IUGR) in a previous pregnancy, placental abruption or fetal death, and maternal comorbid conditions (including type 1 or 2 pregestational diabetes, chronic hypertension, renal disease and autoimmune diseases). Other risk factors include age (women who younger than 20 and older than 40), a history of obesity, first pregnancy and multiple pregnancy (women who are carrying twins, triplets, and other multiples). IUGR refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.

The USPSTF's evidence review found that the daily use of low-dose aspirin can reduce the risk of preeclampsia, premature birth, and IUGR in women who are at increased risk for preeclampsia.

The USPSTF is an independent panel of non-federal government experts that conduct reviews of scientific evidence of preventive health care services. The USPSTF then develops and publishes recommendations for primary care clinicians and health systems in the form of recommendation statements. As part of their recommendations process, the USPSTF will assign definitions to the services they review based on the certainty that a patient will receive a substantial benefit from receiving the benefit. Services that are graded "A" and "B" are highly recommended and the USPSTF believes there is a high certainty that patient will receive a substantial or moderate benefit. 

Under ACA §1001, all of the recommended services receiving grades of "A" or "B" must be provided without cost-sharing when delivered by an in-network health insurance provider. If the recommendation is finalized with the "B" rating, then the use of low-dose aspirin for the prevention of morbidity and mortality from preeclampsia will be required to be covered without cost-sharing under the ACA.

Read the draft recommendation statement at: http://www.uspreventiveservicestaskforce.org/draftrec.htm

Learn more about preventive services covered under the ACA at: HHS.Gov