Xu Ting-ting, Zhou Fan, Deng Chun-yan, Huang Gui-qiong, Li Jin-ke, Wang Xiao-dong
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, China.
J Clin Hypertens (Greenwich). 2015 Jul;17(7):567-73. doi: 10.1111/jch.12541. Epub 2015 Apr 2.
Low-dose aspirin (LDA) is thought to prevent preeclampsia in high-risk pregnancy, but it is not universally used out of concern for its efficacy and safety. The authors meta-analyzed 29 randomized controlled trials (RCTs) to evaluate LDA for preventing preeclampsia and its complications. LDA can reduce the incidence of preeclampsia (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.57-0.87), severe preeclampsia (OR, 0.37; 95% CI, 0.23-0.61), preterm birth (OR, 0.81; 95% CI, 0.75-0.88), and intrauterine growth restriction (IUGR) (OR, 0.80; 95% CI, 0.71-0.90). LDA is more effective in reducing incidence of preeclampsia or IUGR if used before 16 gestational weeks than if used later. LDA increases the incidence of placental abruption (OR, 1.35; 95% CI, 1.05-1.73) but not other major complications. The available evidence suggests that LDA is effective in preventing preeclampsia, preterm birth, and IUGR in high-risk pregnancies without posing a major safety risk to mothers or fetuses.
低剂量阿司匹林（LDA）被认为可预防高危妊娠中的子痫前期，但出于对其疗效和安全性的担忧，它并未得到广泛应用。作者对29项随机对照试验（RCT）进行了荟萃分析，以评估LDA预防子痫前期及其并发症的效果。LDA可降低子痫前期的发生率（优势比[OR]，0.71；95%置信区间[CI]，0.57 - 0.87）、重度子痫前期的发生率（OR，0.37；95% CI，0.23 - 0.61）、早产的发生率（OR，0.81；95% CI，0.75 - 0.88）以及胎儿生长受限（IUGR）的发生率（OR，0.80；95% CI，0.71 - 0.90）。如果在妊娠16周前使用LDA，其在降低子痫前期或IUGR发生率方面比在妊娠16周后使用更有效。LDA会增加胎盘早剥的发生率（OR，1.35；95% CI，1.05 - 1.73），但不会增加其他主要并发症的发生率。现有证据表明，LDA在预防高危妊娠中的子痫前期、早产和IUGR方面有效，且不会对母亲或胎儿构成重大安全风险。
