Prescribing patterns of low-dose aspirin during initial maternity appointments in relation to NICE guideline recommendations: findings from two clinical audits

Dominique Walker* ** | Graham Dark*

*The Medical School, Newcastle University, Newcastle, NE2 4HH

**Newcastle Freeman Hospital, Newcastle upon Tyne, NE7 7DN

Pages: 8-12 ⏐ Published: 24 Jan 2025 ⏐ DOI: https://doi.org/10.70145/MeSh0003

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Two retrospective audits evaluated prescribing patterns of low-dose aspirin in relation to NICE guideline NG133 recommendations during initial maternity appointments at a Northeast Trust, England. The first audit in September 2021 and the second in September 2022 each included the first 299 patients attending initial maternity appointments during those months. Maternity records were analysed to evaluate aspirin prescriptions for patients at moderate or high risk of hypertensive disorders during pregnancy, and prescription rates were compared between the two audits. In the 2022 audit, 49 patients were identified as meeting NG133 criteria for aspirin use, and only 31 (63%) were prescribed aspirin. Of the 18 patients (37%) not prescribed aspirin, five later received aspirin, leaving 4.5% of the total cohort (13/299) untreated. The 2021 audit showed a similar pattern, with 5.6% of patients (15/266) remaining untreated despite meeting NG133 criteria for aspirin use. Key risk factors applicable to those not prescribed aspirin included ‘nulliparous,' 'BMI >35,' and 'pregnancy interval >10 years.' Remote consultations were linked to inadequate BMI assessment, with 35% of applicable cases not evaluated. The audit highlights the necessity for ongoing efforts to enhance guideline adherence in clinical practice, especially with the growing prevalence of remote consultations. Addressing the identified discrepancies could lead to improved outcomes for pregnant women at risk of hypertensive disorders.

Keywords: NICE guidelines, low-dose aspirin prescription, pregnancy

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