Schiff E, Peleg E, Goldenberg M, Rosenthal T, Ruppin E, Tamarkin M, Barkai G, Ben-Baruch G, Yahal I, Blankstein J
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
N Engl J Med. 1989 Aug 10;321(6):351-6. doi: 10.1056/NEJM198908103210603.
We carried out a prospective, randomized, double-blind, placebo-controlled study to investigate the capacity of aspirin to prevent pregnancy-induced hypertension and to alter prostaglandin metabolism. A total of 791 pregnant women with various risk factors for pre-eclamptic toxemia were screened with use of the rollover test (a comparison of blood pressure before and after the woman rolls from her left side to her back) during week 28 or 29 of gestation. Of 69 women with abnormal results (an increase in blood pressure during the rollover test), 65 entered the study and were treated with a daily dose of either aspirin (100 mg; 34 women) or placebo (31 women) during the third trimester of pregnancy. The number of women in whom pregnancy-induced hypertension developed was significantly lower among the aspirin-treated than among the placebo-treated women (4 [11.8 percent] vs. 11 [35.5 percent]; P = 0.024); the same was true for the incidence of preeclamptic toxemia (1 [2.9 percent] vs 7 [22.6 percent]; P = 0.019). The mean ratio of serum levels of thromboxane A2 to serum levels of prostacyclin metabolites after three weeks of treatment decreased by 34.7 percent in the aspirin-treated group but increased by 51.2 percent in the placebo-treated group. No serious maternal or neonatal side effects of treatment occurred in either group. We conclude that low daily doses of aspirin taken during the third trimester of pregnancy significantly reduce the incidence of pregnancy-induced hypertension and pre-eclamptic toxemia in women at high risk for these disorders, possibly through the correction of an imbalance between levels of thromboxane and prostacyclin.
我们进行了一项前瞻性、随机、双盲、安慰剂对照研究，以调查阿司匹林预防妊娠高血压及改变前列腺素代谢的能力。在妊娠第28或29周时，我们使用翻身试验（比较孕妇从左侧卧位翻身至仰卧位前后的血压）对791名有子痫前期各种危险因素的孕妇进行了筛查。在69名结果异常（翻身试验中血压升高）的女性中，65名进入研究，并在妊娠晚期每日服用阿司匹林（100毫克；34名女性）或安慰剂（31名女性）。阿司匹林治疗组发生妊娠高血压的女性人数显著低于安慰剂治疗组（4例[11.8%]对11例[35.5%]；P = 0.024）；子痫前期的发生率也是如此（1例[2.9%]对7例[22.6%]；P = 0.019）。治疗三周后，阿司匹林治疗组血清血栓素A2水平与前列环素代谢产物血清水平的平均比值下降了34.7%，而安慰剂治疗组则上升了51.
