Seminars in perinatology
June 18, 2026 · via Europe PMC
Aspirin and bleeding risk in pregnancy: a clinical review.
Sullivan CO, Merriam AA, Hoffman MK.
AI summary — for doctors, generated from the abstract only
This review highlights that while aspirin's preeclampsia benefit is well established, the obstetric literature lacks robust data on peripartum bleeding risk, raising the question of discontinuation before delivery.
What was studied
A clinical review of bleeding and haemorrhage risk associated with low-dose aspirin use in pregnancy, examining whether aspirin should be discontinued before delivery.
Key findings
- Low-dose aspirin is recommended by nearly every major obstetric society for women at high risk of preeclampsia
- Data on preeclampsia prevention are consistent and robust, particularly for severe early-onset disease
- Signals in the data question the safety of continuation until delivery because of potential increased bleeding risk
- Robust non-pregnant data show bleeding concerns with long-term aspirin use
- The obstetric literature lacks comparably robust studies on bleeding risk around the time of delivery
Clinical relevance
This raises the question of stopping aspirin before planned delivery to limit peripartum bleeding, but the review explicitly notes the obstetric evidence is inadequate to support a recommendation either way, so practice will reasonably vary.
Who should care
Limitations
Narrative clinical review with no systematic search or pooled analysis, reliant on extrapolation from non-pregnant populations because the obstetric bleeding literature the authors sought does not exist in robust form.
Nobody knows whether to stop aspirin before delivery, and this review makes clear the evidence to decide is missing.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Low-dose aspirin is recommended by nearly every major obstetric society for women at high risk of preeclampsia. There is consistent and robust data surrounding preeclampsia prevention, particularly severe early-onset disease; however, there are signals in the data that question the safety of continuation until delivery due to potential increased risk of bleeding. There is robust data from the non-pregnant population that demonstrates concern with long-term aspirin use and bleeding risk. The obstetric literature lacks such robust studies around bleeding concerns, particularly around the time of delivery in individuals using aspirin in pregnancy. This review provides a comprehensive, review of bleeding and hemorrhage risk associated with aspirin use in pregnancy and highlights the consideration for aspirin discontinuation prior to delivery.
DOI
10.1016/j.semperi.2026.152267
PMID
42315428
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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