Preeclampsia

Administering of Low-Dose Aspirin to prevent Preeclampsia Student’s Name: Institution: Administering of Low-Dose Aspirin to prevent Preeclampsia Statement of the Problem, Significance, Scope, and Burden Topic In spite of studies evaluating the effectiveness of low-dose aspirin as a prevention of preeclampsia, the evidence is insufficient to inform stakeholders on the policies to put in place to facilitate the efficiency of the administration of the drug. The current review of literature examines alternative policy interventions that would determine how healthcare systems globally use low-dose aspirin to treat preeclampsia. Scope and Burden of Preeclampsia Preeclampsia affects pregnant women and is the leading cause of morbidity and mortality for mothers and babies in the United States and globally. In particular, the health condition increases the risk of preterm delivery raising the risk of death resulting from pregnancy. Preeclampsia causes high blood pressure among pregnant women and is associated with high levels of protein in the urine. Women with chronic high blood pressure, history of preeclampsia, type I or type II diabetes, or kidney disease are at a high risk of preeclampsia. The epidemiology of preeclampsia is 5-8% of all births and the rate has increase by 25% in the United States in the past two decades (5,6). Consequently, the care of pregnant women in consideration of the prevention of preeclampsia is critical in the healthcare system. While there are risk factors indicating a high likelihood of pregnant women developing preeclampsia, the condition could affect any woman during pregnancy and postpartum (4). In the United States, racial and ethnic minorities are disproportionately affected by preeclampsia. Studies have found that the most clinical method for preventing preeclampsia is the administration of low-dose aspirin to pregnant women (1,5,8). This approach could save lives and increase the quality of health for the mothers and babies globally. While the administering of low-dose aspirin has a significant reduction in the exposure of pregnant women to preeclampsia, the difference is small. The critical policy question for researchers and policy-makers is how they intend to administer low-dose aspirin in the most efficient manner (7). Determining how the health of mothers responds differently to women in different categories would shed light on the policies healthcare organizations and systems should make justified by primary research. Moreover, determining the effects of the treatment on the health outcomes pregnant women and babies would indicate the need to research and develop alternative treatments for preeclampsia. The impact of preeclampsia on pregnant mothers and babies is a key reason to consider the policies on the use of low-dose aspirin for prevention. Critical Literature Review Policy Interventions Effective interventions for preeclampsia could save the lives of mothers and babies and lead to healthy deliveries. The administration of low-dose aspirin is the best-known intervention for the prevention of preeclampsia among pregnant women in the globally. The studies included in this review of literature describe different administration procedures that determine the target women for the use of aspirin to prevent preeclampsia. Determining the most effective approach to determine the target patients for the current treatment would improve the health outcomes of pregnant women globally. One of the interventions is the administration of aspirin to all pregnant women to lower the incidents of preeclampsia. Health systems using this approach would recommend that all pregnant women receive a low dosage of aspirin from the second trimester. An alternative intervention is to administer low-dose aspirin among women at a high risk of preeclampsia. Through this intervention, the risk factors for preeclampsia are identified to determine the women who are at a high risk. They include chronic hypertension, women with a history of preeclampsia, type 1 and 2 diabetes, and low pregnancy-associated plasma protein A (PAPP-A), and kidney disease. While targeting high-risk pregnant women would provide intervention to those likely to develop preeclampsia, the intervention leaves out the low-risk pregnant women. In addition to limiting the administration of low-dose aspirin to high risk pregnant women, the literature search identified interventions targeting women with hypertension. This intervention provides care to women with hypertension and leaves out high risk women with normotension. High blood pressure is a critical factor influencing the prevalence of preeclampsia and this intervention approach excludes other women from low-dose aspirin administration. Alternatively, the literature search revealed the administration of calcium doses alongside low-dose aspirin as an intervention for preeclampsia. Pregnant women, regardless of their risk levels of preeclampsia, are provided with low-dose aspirin alongside a calcium dosage beginning in the second trimester. Racial and ethnic prevalence of illnesses is a critical consideration for healthcare organizations particularly in diverse societies. It is critical that healthcare organizations develop interventions that are effective among individuals of all races and ethnic groups. The last intervention approach is based on the administration of low-dose aspirin while considering the race and ethnicity of pregnant women. Providing care based on the effectiveness among women from different racial groups would ensure equality in treatment among diverse communities. Synthesis of Results Administering Aspirin to All Women Studies conducted involving pregnant women from different countries as revealed by the literature such (12). The study targeting all women involved participants from the Democratic Republic of Congo, India, Kenya, Zambia, Pakistan, and Guatemala reveled that low-dose aspirin initiated between 6 and 13 weeks and 6 days reduces preterm deliveries (12). The provision of low-dose aspirin among all pregnant women is a critical intervention for preeclampsia. According to the findings of the study, preterm deliveries before 37 weeks were lower for the treatment group compared to the placebo group. The research demonstrated that perinatal mortality reduced among the group where aspirin was administered to the pregnant women. A system review and meta-analysis on the same population showed that while low-dose aspirin lowered the risk of preterm preeclampsia, there was no impact on term preeclampsia (13). While the studies differed in methodology, the resulted to similar outcomes on the effectiveness of low-dose aspirin on pregnant women. Administering Aspirin to All High-Risk Women Determining the risk factors for preeclampsia plays a critical role in research on the effectiveness of low-dose aspirin as an intervention approach. Studies have revealed different results on how the administration of aspirin affects the health outcomes of the mother and child. In a study in the United States involving 186 women with chronic hypertension, 191 with diabetes, and 146 women with prior preeclampsia, the administration of low-dose aspirin at 60 mg/day of low dose aspirin reduced late-onset preeclampsia by 26 % (2). The participants in the study were initiated with the treatment at <17w0d and the findings showed that the intervention was effective in reducing the incidence of preeclampsia. While this study conducted in the United States showed low-dose aspirin to be effective, a randomized control study in care facilities in China reveled no benefits of low-dose aspirin on high risk women (3). 1000 pregnant women were treated with 100mg low-dose aspirin or a placebo and the findings showed no significant difference between the groups in the health of the mother