Ma'ayeh Marwan, Rood Kara M, Kniss Douglas, Costantine Maged M
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA. Marwan.Ma'
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA.
Curr Hypertens Rep. 2020 Feb 12;22(2):17. doi: 10.1007/s11906-020-1026-8.
To review the rationale and biological plausibility and discuss the current research on novel interventions for the prevention of preeclampsia.
Preeclampsia affects up to 8% of pregnancies worldwide and remains a major cause of maternal and neonatal morbidity and mortality. Multiple medications have been investigated or repurposed as potential effective interventions for preeclampsia prevention. Aspirin is currently the only drug for which there is some evidence of benefit for preeclampsia prevention, and its use is recommended by professional societies for pregnancies at risk. Statins have shown promise for prevention of preeclampsia in animal models and human pilot studies, without any trend or concerns for safety signals or teratogenicity. The use of metformin has also gained popularity in experimental studies, but observations from randomized clinical trials were not consistent on its utility as a possible intervention for preeclampsia prevention. While initial studies evaluating esomeprazole were promising, randomized trials failed to show benefit. Contemporary research shows exciting new opportunities for prophylactic treatment for preeclampsia, to prevent this debilitating and life-threatening disease.
回顾预防子痫前期新干预措施的理论依据和生物学合理性,并讨论当前相关研究。
子痫前期影响全球多达8%的妊娠,仍然是孕产妇和新生儿发病及死亡的主要原因。多种药物已被研究或重新用于作为预防子痫前期的潜在有效干预措施。阿司匹林是目前唯一有一些证据表明对预防子痫前期有益的药物,专业学会建议有风险的孕妇使用。他汀类药物在动物模型和人体初步研究中显示出预防子痫前期的前景,没有任何安全信号或致畸性的趋势或担忧。二甲双胍在实验研究中的应用也越来越普遍,但随机临床试验的观察结果在其作为预防子痫前期可能干预措施的效用方面并不一致。虽然最初评估埃索美拉唑的研究很有前景,但随机试验未能显示出益处。当代研究为子痫前期的预防性治疗带来了令人兴奋的新机会,以预防这种使人衰弱和危及生命的疾病。