Aspirin in the Prevention of Fetal Growth Restriction: Its Mechanisms and Clinical Outcomes
Main Article Content
Abstract
Background: Foetal growth restriction (FGR) is a serious pregnancy complication associated with long-term adverse outcomes, neonatal morbidity, and stillbirth. Its primary causes include inadequate spiral arterial remodelling, endothelial dysfunction, and reduced placental perfusion. Low-dose aspirin (LDA) has been extensively studied for improving uteroplacental blood flow through its antiplatelet, anti-inflammatory, and vasodilatory effects. Initiating aspirin before 16 weeks of gestation significantly reduces FGR risk in high-risk pregnancies. Main Body: A literature review was conducted using PubMed and related databases to identify clinical trials, meta-analyses, and guideline statements assessing aspirin for FGR and preeclampsia prevention. Key search terms included low-dose aspirin, foetal growth restriction, preeclampsia, placental insufficiency, and pregnancy complications. Studies from India were reviewed separately to highlight regional evidence variations. Results: Randomized trials and meta-analyses indicate that aspirin enhances uteroplacental circulation, lowers preeclampsia risk, and reduces FGR incidence, particularly when started before 16 weeks at 100–150 mg daily. Safety outcomes are favourable, with minimal maternal or neonatal adverse effects at recommended doses. However, compliance and outcomes vary due to differences in healthcare access, antenatal care timing, and practices. In India, limited large-scale studies and inconsistent guidelines have hindered routine aspirin use in obstetric care. Conclusion: Low-dose aspirin is a safe, cost-effective intervention that reduces FGR and associated complications when initiated early in high-risk pregnancies. Despite global recommendations, its use remains suboptimal in some regions, including India. Population-specific trials and standardized national protocols are needed to optimize clinical benefits.
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Authors
Shalini Sivadasan
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