Q&A: How low-dose aspirin in pregnancy can reduce heart disease risk for Black women

Key takeaways:

• Preeclampsia is common for Black women, but they are not often told about aspirin use to reduce risk.
• An initiative aims to improve administration and knowledge of prenatal aspirin to reduce preeclampsia risk.

The Preeclampsia Foundation launched a new initiative that aims to close the maternal health equity gap and promote the use of low-dose aspirin to reduce preeclampsia risk in Black women.

“We know in this country that maternal mortality for Black women is at least two times higher than that for non-Hispanic white women, and in some areas of this country that can be as much as 12 times higher,” Cornelia R. Graves, MD, maternal-fetal medicine subspecialist at Tennessee Maternal Fetal Medicine and member of the Preeclampsia Foundation’s Medical Advisory Board, told Healio. “We are looking for innovative ways to lower this gap.”

In partnership with health care marketing agency Patients & Purpose, the Preeclampsia Foundation launched GAP–SPIRIN, an evidence-based education campaign to encourage the use of low-dose aspirin to reduce preeclampsia risk.

GAP–SPIRIN will launch in five ZIP codes in New York City identified to have high preeclampsia and maternal mortality risk, which will primarily serve Black populations, according to a press release. With GAP–SPIRIN, 100 community obstetric health care provider offices receive a package including resources and education about disparities and aspirin as a preventive preeclampsia treatment and providers will be invited to submit reflections on current maternal health practices and prescribing habits and pledge to help ”close the maternal health gap.”

Healio spoke with Graves about the GAP–SPIRIN initiative, how it works and its importance in maternal health.

Healio: What are some reasons Black mothers are not informed about an aspirin regimen early in pregnancy to reduce preeclampsia risk?

Graves: Often, pregnant women who have resource issues may enter into care late, so after the time where aspirin may be initiated, which is about 22 weeks. Many Black women don’t have resource issues, and they enter into care at the appropriate time; however, their clinician may be unaware that, for example, a woman who is 40 and Black is a candidate for aspirin. A woman who is Black and pregnant with her first baby is also a candidate for aspirin. Women do not have to have high blood pressure, diabetes or twin gestations to be candidates for aspirin.

The GAP–SPIRIN initiative aims close the gap and improve the administration and the knowledge of the use of aspirin in pregnancy for both patients and providers. The Preeclampsia Foundation has been very active in providing educational information. Part of the GAP–SPIRIN project is for us to get the word out. I think that’s always important. If a patient comes in and says, “Am I a candidate for aspirin?” that can trigger the provider to provide her with those resources.

Healio: Why hasn’t an initiative like this one launched sooner?

Graves: No. 1 is a lack of awareness about our maternal health mortality crisis in this country, and particularly a lack of awareness in other communities besides the Black community about the increased disparity in that community. Often, once we get our national data out, we try to reach all women because I always point out that while our gaps are not great for non-Hispanic Black women, we’re really not setting a bar for any woman who gives birth in this country. Black women have also become more vocal about their birthing experiences and have become activists for their own health care.

Black women are also more likely to get preeclampsia, so we’re also more likely to have those stories where a woman might say, “If I had known that if I was 35 and this was my first baby, and I was Black, that I should ask my doctor for aspirin, that could have changed my course.” Aspirin is cheap. It is readily available. It does not require prescription. I cannot think of any reason why we shouldn’t be using it.

Healio: Is there anything else you would like to add?

Graves: We are developing two checklists. The first is for health care providers so that they will be reminded to mark if a patient has high and/or moderate preeclampsia risk factors. The second preeclampsia risk factor checklist can be self-completed by patients before the initial visit.

Last but not least, the Preeclampsia Foundation urges women to participate in research as part of this effort as well because what we do know is that in some research, some doses of aspirin are not as effective in Black women. We need to make sure that we are providing evidence-based care to all of our patients.

For more information:

Cornelia R. Graves, MD, can be reached at cgraves@tnmfm.com; X (Twitter): @preeclampsia.

Reference:

• Preeclampsia Foundation Launches GAP–SPIRIN: a creative intervention for Black maternal health. Published Jan. 23, 2025. Accessed Jan. 23, 2025. www.prnewswire.com/news-releases/preeclampsia-foundation-launches-gapspirin-a-creative-intervention-for-black-maternal-health-302358047.html.