Lan Patrick G, Gillin Adrian G, Pelosi Marilena, Tooher Jane, Sandager Puk, Hyett Jon
a School of Medicine , University of Sydney , Sydney , Australia.
b Department of Renal Medicine , Royal Prince Alfred Hospital , Camperdown , Australia.
J Matern Fetal Neonatal Med. 2019 Jul;32(13):2137-2142. doi: 10.1080/14767058.2018.1427718. Epub 2018 Jan 24.
Low-dose aspirin (LDA) therapy has been found to be effective in preventing the development of early-onset preeclampsia. However, its effect on late-onset preeclampsia has not been described. Our study was aimed at determining if LDA therapy prescribed from early in pregnancy modified the severity of late-onset preeclampsia.
A retrospective analysis of all women who were screened for early-onset preeclampsia at 11-13 weeks' gestation between April 2012 and October 2014 at our institution, and who subsequently developed late-onset preeclampsia. The treatment group consisted of women who were prescribed LDA therapy from early in pregnancy as a result of the screening. The control group consisted of women who did not receive LDA therapy.
The aspirin group was associated with earlier delivery at 38.0 (37.5-38.5) weeks' gestation versus 39.0 (38.7-39.4) weeks' gestation for the nonaspirin group (p < .01). The aspirin group was also associated with lower absolute birth weight 2851 (2646-3055) versus 3215 (3068-3362) grams in the nonaspirin group (p < .01). However, when normalised for gestational age at delivery, the proportion of foetuses that were small for gestation age (< 10th centile) were not significantly different between the two groups [28% in aspirin group versus 23% in nonaspirin group; p = .62]. No other significant difference was noted.
There was no difference in the clinical severity of late-onset preeclampsia between women screened as high risk for early-onset preeclampsia and subsequently prescribed LDA during their pregnancy, compared to women found to be at low risk and not prescribed LDA.
已发现小剂量阿司匹林（LDA）疗法在预防早发型子痫前期的发生方面有效。然而，其对晚发型子痫前期的影响尚未见描述。我们的研究旨在确定孕期早期开始使用的LDA疗法是否会改变晚发型子痫前期的严重程度。
对2012年4月至2014年10月在我们机构于妊娠11 - 13周时接受早发型子痫前期筛查且随后发生晚发型子痫前期的所有女性进行回顾性分析。治疗组由因筛查从孕期早期就被给予LDA疗法的女性组成。对照组由未接受LDA疗法的女性组成。
阿司匹林组的分娩孕周较早，为38.0（37.5 - 38.5）周，而非阿司匹林组为39.0（38.7 - 39.4）周（p < 0.01）。阿司匹林组的出生绝对体重也较低，为2851（2646 - 3055）克，非阿司匹林组为3215（3068 - 3362）克（p < 0.01）。然而，按分娩时的孕周进行标准化后，两组中小于胎龄儿（<第10百分位数）的比例无显著差异[阿司匹林组为28%，非阿司匹林组为23%；p = 0.62]。未发现其他显著差异。
与被发现为低风险且未使用LDA的女性相比，被筛查为早发型子痫前期高风险且在孕期随后使用LDA的女性，其晚发型子痫前期的临床严重程度无差异。
