Low-dose aspirin to prevent preeclampsia in women at high risk
Low-dose aspirin to prevent preeclampsia in women at high risk
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DOI：
10.1056/nejm199803123381101
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发表时间：
1998-03-12
影响因子：
158.5
通讯作者：
Thurnau, G
中科院分区：
文献类型：
--
作者：
Caritis, S;Sibai, B;Thurnau, G
背景低剂量阿司匹林是否能预防子痫前期尚不清楚。不推荐低风险先兆子痫的妇女使用，但可以减少高风险妇女的发病率。方法采用双盲、随机、安慰剂对照的方法，对4组高危子痫孕妇进行研究，包括471例妊娠期胰岛素治疗糖尿病妇女、774例慢性高血压妇女、688例多胎妊娠妇女和606例既往妊娠子痫妇女。这些妇女在妊娠13周至26周期间被招募，每天服用60毫克阿司匹林或安慰剂。结果：2539名参与研究的女性中，除36名外，其余均获得了结果数据。1254名服用阿司匹林的妇女和1249名服用安慰剂的妇女的先兆子痫发生率相似（阿司匹林，18%；安慰剂，20%；P=0.23）。阿司匹林组和安慰剂组在四种高危类别中的发病率也相似：对于患有妊娠糖尿病的妇女，阿司匹林组的发病率为18%，安慰剂组的发病率为22% (P=0.38)；女性慢性高血压患者分别为26%和25% (P=0.66)；多胎妊娠患者分别为12%和16% (P=0.10)；而在之前怀孕期间有先兆子痫的孕妇，分别为17%和19% （P=0.47）。此外，阿司匹林组和安慰剂组围产期死亡、早产和小于胎龄婴儿的发生率相似。结论：在我们的研究中，低剂量阿司匹林并没有显著降低子痫前期的发生率，也没有显著改善子痫前期高危孕妇的围产儿结局。(C) 1998年，马萨诸塞州医学协会。
Background Whether low-dose aspirin prevents preeclampsia is unclear. It is not recommended as prophylaxis in women at low risk for preeclampsia but may reduce the incidence of the disease in women at high risk.Methods We conducted a double-blind, randomized, placebo-controlled trial in four groups of pregnant women at high risk for preeclampsia, including 471 women with pregestational insulin-treated diabetes mellitus, 774 women with chronic hypertension, 688 women with multifetal gestations, and 606 women who had had preeclampsia during a previous pregnancy. The women were enrolled between gestational weeks 13 and 26 and received either 60 mg of aspirin or placebo daily.Results Outcome data were obtained on all but 36 of the 2539 women who entered the study. The incidence of preeclampsia was similar in the 1254 women in the aspirin group and the 1249 women in the placebo group (aspirin, 18 percent; placebo, 20 percent; P=0.23). The incidences in the aspirin and placebo groups for each of the four high-risk categories were also similar: for women with pregestational diabetes mellitus, the incidence was 18 percent in the aspirin group and 22 percent in the placebo group (P=0.38); for women with chronic hypertension, 26 percent and 25 percent (P=0.66); for those with multifetal gestations, 12 percent and 16 percent (P=0.10); and for those with preeclampsia during a previous pregnancy, 17 percent and 19 percent (P=0.47). In addition, the incidences of perinatal death, preterm birth, and infants small for gestational age were similar in the aspirin and placebo groups.Conclusions In our study, low-dose aspirin did not reduce the incidence of preeclampsia significantly or improve perinatal outcomes in pregnant women at high risk for preeclampsia. (C) 1998, Massachusetts Medical Society.