Effectiveness of Higher Aspirin Dosing for Prevention of Preeclampsia in High Risk Obese Gravida

Inclusion Criteria * A singleton gestation at less than 20 weeks at time of enrollment, with a BMI greater than or equal to 30 and one of the following: 1\. History of preeclampsia in a prior pregnancy * Diagnosis will be obtained by review of records, and if unavailable then patient history. Preeclampsia diagnosis may be made in antepartum or postpartum period. OR 2. At least stage I hypertension during pregnancy * Stage I hypertension is defined as a systolic blood pressure between 130- 139 mm Hg or diastolic blood pressure between 80-89 mm Hg21 * This blood pressure criteria is met regardless of medication usage * The patient must have a blood pressure reading ≥ 130-139/80-89 mm Hg at least during 1 clinic visit during the current pregnancy; before or at time of enrollment OR 3\. Pre-gestational diabetes * Type 1 and Type 2 diabetics are included * Gestational diabetes mellitus diagnosed prior to 20 weeks gestational age will also be included Exclusion Criteria * Known allergy/prior adverse reaction/any medical condition where aspirin is contraindicated * Already on aspirin prior to pregnancy * Baseline renal Disease * Baseline proteinuria identified at time of enrollment, defined as urine analysis with 3+ protein, or urine protein to creatinine ratio ≥ 0.3 * Systemic Lupus Erythematosus * Seizure disorder on medications * HIV positive status * Known major fetal anomalies * Multifetal gestation