The efficacy of low-dose aspirin in pregnancy among women in malaria-endemic countries.
The efficacy of low-dose aspirin in pregnancy among women in malaria-endemic countries.
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DOI：
10.1186/s12884-022-04652-9
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发表时间：
2022-04-10
影响因子：
3.1
通讯作者：
Bose CL
中科院分区：
文献类型：
--
作者：
Bauserman M;Leuba SI;Hemingway-Foday J;Nolen TL;Moore J;McClure EM;Lokangaka A;Tsehfu A;Patterson J;Liechty EA;Esamai F;Carlo WA;Chomba E;Goldenberg RL;Saleem S;Jessani S;Koso-Thomas M;Hoffman M;Derman RJ;Meshnick SR;Bose CL
低剂量阿司匹林（LDA）是减少早产的有效策略。然而，根据早产的病因，LDA可能在全球范围内具有不同的效果。在一些地区，妊娠期疟疾可能是LDA对出生结局和贫血的重要调节因素。这是阿司匹林试验的一个子研究，一个多国，随机，安慰剂对照试验评估LDA对早产的影响。我们在阿司匹林试验中招募了来自刚果民主共和国（DRC）、肯尼亚和赞比亚的方便女性样本。我们用定量聚合酶链反应检测疟疾。我们计算了疟疾导致LDA的粗患病率比例比率（pr），并建立了回归模型来评估效果测量方法的修改。我们在妊娠早期疟疾感染的基础上评估妊娠晚期的血红蛋白。对1446名妇女进行了分析，其中刚果民主共和国地点的疟疾患病率为63%，肯尼亚地点为38%，赞比亚地点为6%。早产发生率分别为83例（LDA组）和90例（安慰剂组）（PR 0.92, 95% CI 0.70, 1.22）， LDA和疟疾之间无相互作用（p = 0.75）。围产期死亡率为41例（LDA组）和43例（安慰剂组），（PR 0.95, 95% CI 0.63, 1.44），疟疾和LDA组之间存在相互作用（p = 0.014）。血红蛋白与疟疾和LDA状态相似。妊娠早期疟疾没有改变LDA对早产的影响，但改变了LDA对围产期死亡率的影响。随着LDA在疟疾流行地区的应用，这种效应测度的修改值得继续研究。
Low dose aspirin (LDA) is an effective strategy to reduce preterm birth. However, LDA might have differential effects globally, based on the etiology of preterm birth. In some regions, malaria in pregnancy could be an important modifier of LDA on birth outcomes and anemia. This is a sub-study of the ASPIRIN trial, a multi-national, randomized, placebo controlled trial evaluating LDA effect on preterm birth. We enrolled a convenience sample of women in the ASPIRIN trial from the Democratic Republic of Congo (DRC), Kenya and Zambia. We used quantitative polymerase chain reaction to detect malaria. We calculated crude prevalence proportion ratios (PRs) for LDA by malaria for outcomes, and regression modelling to evaluate effect measure modification. We evaluated hemoglobin in late pregnancy based on malaria infection in early pregnancy. One thousand four hundred forty-six women were analyzed, with a malaria prevalence of 63% in the DRC site, 38% in the Kenya site, and 6% in the Zambia site. Preterm birth occurred in 83 (LDA) and 90 (placebo) women, (PR 0.92, 95% CI 0.70, 1.22), without interaction between LDA and malaria (p = 0.75). Perinatal mortality occurred in 41 (LDA) and 43 (placebo) pregnancies, (PR 0.95, 95% CI 0.63, 1.44), with an interaction between malaria and LDA (p = 0.014). Hemoglobin was similar by malaria and LDA status. Malaria in early pregnancy did not modify the effects of LDA on preterm birth, but modified the effect of LDA on perinatal mortality. This effect measure modification deserves continued study as LDA is used in malaria endemic regions.
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影响因子：
3.4
作者：
Lassi ZS;Mansoor T;Salam RA;Das JK;Bhutta ZA
通讯作者：
Bhutta ZA
影响因子：
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作者：
Hoffman, Matthew K.;Goudar, Shivaprasad S.;Derman, Richard J.
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Derman, Richard J.
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Bujold, E.
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作者：
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通讯作者：
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影响因子：
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