A $.03 pill that could save maternal lives: low dose aspirin.... Part 3

Who faces the highest risk, and which groups are overlooked?

Preeclampsia does not affect all women equally. In the United States, Black women face disproportionately higher rates of preeclampsia, higher rates of severe complications, and maternal mortality from preeclampsia that far exceeds that of White women. These disparities result from unequal access to early prenatal care, evidence-based interventions, and structural racism. An underlying flaw in the research is that most clinical trials enrolled predominantly White patients, limiting our ability to draw firm conclusions about who benefits most across race and ethnicity. There is a significant need for more inclusive research.

Public health campaigns 2024-2025

• Several major U.S. initiatives are working to turn evidence into clinical action: March of Dimes and CMQCC (California Maternal Quality Care Collaborative) co-developed a detailed implementation guide in 2024. This free guide gives clinical teams real-world tools, patient communication scripts, EHR optimization tips, and lessons from early-adopter clinics.
• The Preeclampsia Foundation launched updated educational resources in 2024 and 2025,including the "Ask About Aspirin"; campaign and a new "My Health Beyond Pregnancy" resource focused on long-term cardiovascular health monitoring for preeclampsia survivors.
• At the 2025 ACOG Annual Clinical Scientific Meeting, a study presented by Mount Sinai researchers showed that switching from risk-stratified to universal LDA prescribing (giving aspirin to all eligible prenatal patients without requiring individualized risk scoring) dramatically increased uptake and was particularly beneficial in underserved populations.
• A 2025 study at a Federally Qualified Health Center (FQHC) serving a socially vulnerable population proved that with implementation of a universal LDA protocol, adherence jumped from 8.7% to 75%, and preeclampsia with severe features fell by 86% in the intervention cohort.

By Brittany de Soto Palmer