睡前口服小剂量阿司匹林预防高危孕妇子痫前期的发生  

Low-dose Aspirin Prescribed at Bed Time for the Prevention of Pre-eclampsia in High-risk Pregnant Women

作　　者：赵应梅[1] 肖丽萍[1] 胡花[1] 杨晓宁[1] 许依群[1] 郭丽梅[1] 

机构地区：[1]上海市浦东新区南汇中心医院妇产科,上海201300

出　　处：《生殖与避孕》2012年第5期355-359,共5页Reproduction and Contraception

摘　　要：目的：探讨小剂量阿司匹林对高危孕妇子痫前期及妊娠诱发的高血压综合征的预防作用。方法：将242例存在子痫前期高危因素暴露的孕13-16周的妇女随机分成阿司匹林处理组（n=120，睡前口服75mg阿司匹林至分娩）和对照组（n=122，安慰剂替代阿司匹林），随访至妊娠结束后2周，记录子痫及妊娠高血压综合征的发生率。结果：本研究中共失访5例，其中阿司匹林组2例，对照组3例。子痫前期的发生率，阿司匹林组低于对照组（18。6％VS52。9％），其中轻度子痫前期、早发子痫前期、严重子痫前期的发生率阿司匹林组（11．0％、3．4％、4．2％）均低于对照组（26．9％、12．6％、13．4％）。妊娠诱发高血压的发生率（4．2％VS16．0％）、宫内发育迟缓发生率（13．6％VS30．3％）、出生孕周〈34周的孕妇比例（4．2％VS13．4％）、37周前分娩的孕妇比例（18．6％VS40．3％）、流产比例（2．5％w10．1％），阿司匹林组均低于对照组。平均出生体质量（2890±340gvs2611±79g）、平均出生孕周（36．8±2．0FS35．0±3．1），阿司匹林组大于对照组（P〈0．05）。阿司匹林组与对照组在新生儿围产期内死亡率（O．8％VS1．7％）、胎盘早剥率（6．8％VS5．O％）、阴道分娩率（43．2％VS40．3％）之间均无统计学差异（P＞0．05）o结论：睡前口服小剂量阿司匹林能使子痫前期高危孕妇受益。Objective： To assess the effectiveness of low-dose aspirin in the prevention of pre-eclampsia and hypertensive complications in high-risk pregnant women. Methods： The trial enrolled 242 women at high risk ofpre- eclampsia at 13-16 weeks of gestation. The women were randomly allocated into two groups, one receiving aspirin （75 mg/d orally at bed time till delivery, n=120） and the other serving as the control （placebo instead of aspirin, n=122）. All women were followed up until two weeks after delivery to assess maternal and perinatal outcomes. Results： Preeclampsia developed in 18.6% of women receiving aspirin and 52.9% of women in control group, with a lower rate of mild pre-eclampsia （11.0% vs 26.9%）, early-onset pre-eclampsia （3.4% vs 12.6%）, severe pre- eclampsia （4.2% vs 13.4%） and pregnancy-induced hypertension （4.2% vs 16.0%）, respectively. The mean birthweight was higher in aspirin group than in control group （2 890±340 g vs 2 611±479 g）, with a lower rate of IUGR of new horns （13.6% vs 30.3%）. Preterm delivery before 34 weeks of gestation was recorded in only 4.2% of women receiving aspirin as opposed to 13.4% of controls, with a lower rate ofpreterm delivery before 37 weeks （18.6% vs 40.3%）, with a lower miscarriage rate （2.5% vs 10.1%）, but with a higher average delivery weeks （36.8±2.0 weeks vs 35.0±3.1 weeks）. The above difference was statistically significant （P〈0.05）, but there was no significant difference between the two groups in the rate of abruption placenta, mode of delivery and perinatal death. Conclusion： These limited data give some support to the potential favourable effect of early treatment with low-dose aspirin as early as 13-16 weeks in pregnant women at high risk of preeclampsia.

关 键 词：阿司匹林 子痫前期 妊娠诱发高血压 

分 类 号：R714.244[医药卫生—妇产科学]