Of Aspirin, Preeclampsia, and Racism

( N Engl J Med . 2024;390(11):968–969. doi: 10.1056/NEJMp2311019) Being African American/Black was listed as a factor associated with a moderate level of preeclampsia risk in 2018 as outlined by the American College of Obstetricians and Gynecologists (ACOG) committee. This opinion was also re-affirmed in 2023. In 2021 and again in 2022, ACOG cited it as a proxy for the adverse effects of racism on health and mentioned that Black race on its own could be an indication for the need for aspirin. In general, if more than one moderate risk factor was present, a low dose of aspirin could be used to help prevent preeclampsia. This article investigates whether race itself is a risk factor, the potential role of structural racism contributing to preeclampsia, and whether aspirin helps prevent it in this demographic.