Purpose <p>Daily low-dose aspirin (LDA) is guideline recommended for preeclampsia prevention, but racial/ethnic disparities persist in its implementation. This systematic review examines disparities in LDA prescription, recommendation and adherence for preeclampsia risk reduction among Black patients compared with other racial/ethnic groups in the United States.</p> Recent findings <p>Overall, LDA prescription/recommendation rates range widely across included studies, from 10.7% to 95% among eligible patients. Black patients are shown to have a similar prescription/recommendation rate compared to White patients. Adherence rates average around 70%, with Black patients showing lower adherence rates despite similar prescription/recommendation rates than White patients. Barriers identified included inconsistent counseling, limited access to prenatal care, and distrust of the healthcare system.</p> Summary <p>While prescribing practices for LDA appear increasingly equitable across racial/ethnic groups, significant disparities remain in adherence among Black women, potentially contributing to worse maternal outcomes. Reducing these gaps requires culturally tailored patient education, improved physician–patient communication, and systems-level interventions that integrate adherence monitoring into prenatal care.</p>

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Low-Dose Aspirin Recommendations for Preeclampsia Risk Reduction: A Systematic Review Focused on Black Patients

  • Yitian Zha,
  • Natalie J Mikhailov,
  • Krishna H Brucia,
  • Juan Gao,
  • Emily Alleman,
  • Keith C Ferdinand

摘要

Purpose

Daily low-dose aspirin (LDA) is guideline recommended for preeclampsia prevention, but racial/ethnic disparities persist in its implementation. This systematic review examines disparities in LDA prescription, recommendation and adherence for preeclampsia risk reduction among Black patients compared with other racial/ethnic groups in the United States.

Recent findings

Overall, LDA prescription/recommendation rates range widely across included studies, from 10.7% to 95% among eligible patients. Black patients are shown to have a similar prescription/recommendation rate compared to White patients. Adherence rates average around 70%, with Black patients showing lower adherence rates despite similar prescription/recommendation rates than White patients. Barriers identified included inconsistent counseling, limited access to prenatal care, and distrust of the healthcare system.

Summary

While prescribing practices for LDA appear increasingly equitable across racial/ethnic groups, significant disparities remain in adherence among Black women, potentially contributing to worse maternal outcomes. Reducing these gaps requires culturally tailored patient education, improved physician–patient communication, and systems-level interventions that integrate adherence monitoring into prenatal care.