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低剂量阿司匹林用于预防双胎妊娠不良妊娠结局:基于倾向评分匹配的观察性队列研究。

Low-dose aspirin for primary prevention of adverse pregnancy outcomes in twin pregnancies: an observational cohort study based on propensity score matching.

机构信息

Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

出版信息

BMC Pregnancy Childbirth. 2021 Nov 22;21(1):786. doi: 10.1186/s12884-021-04217-2.

Abstract

BACKGROUND

Since the effectiveness of low-dose aspirin (LDA) in twin pregnancies is uncertain, we aimed to preliminarily assess whether LDA is beneficial in preventing preeclampsia in twin pregnancies.

METHODS

This study is an observational study in two hospitals in China. Among 932 women, 277 in the First Affiliated Hospital of Chongqing Medical University were routinely treated with aspirin (100 mg daily) from 12 to 16 weeks to 35 weeks of gestational age, while 655 in Chongqing Health Center for Women and Children were not taking aspirin during pregnancy. We followed each subject and the individual details were recorded.

RESULTS

LDA significantly reduced the risk of preeclampsia (RR 0.48; 95% CI 0.24-0.95) and preterm birth 34 weeks (RR 0.50; 95% CI 0.29-0.86) and showed possible benefits to lower the rate of SGA babies (RR 0.74; 95% CI 0.55-1.00). Moreover, the risk of postpartum hemorrhage was not increased by LDA (RR 0.89; 95% CI 0.35-2.26).

CONCLUSIONS

Treatment with low-dose aspirin in twin pregnancies could offer some protection against adverse pregnancy outcomes in the absence of significantly increased risk of postpartum hemorrhage.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR); ChiCTR-OOC-16008203 , Retrospectively registered date: April 1st, 2016.

摘要

背景

由于低剂量阿司匹林(LDA)在双胎妊娠中的有效性尚不确定,我们旨在初步评估 LDA 是否有益于预防双胎妊娠子痫前期。

方法

这是一项在中国两家医院进行的观察性研究。932 名妇女中,重庆医科大学第一附属医院的 277 名妇女从 12 周到 16 周至 35 周妊娠龄常规接受 100mg 每日阿司匹林治疗,而重庆妇幼保健中心的 655 名妇女在怀孕期间未服用阿司匹林。我们对每个受试者进行随访,并记录个体详细信息。

结果

LDA 显著降低子痫前期的风险(RR 0.48;95%CI 0.24-0.95)和早产 34 周(RR 0.50;95%CI 0.29-0.86),并可能降低 SGA 婴儿的发生率(RR 0.74;95%CI 0.55-1.00)。此外,LDA 并未增加产后出血的风险(RR 0.89;95%CI 0.35-2.26)。

结论

在双胎妊娠中使用低剂量阿司匹林治疗可以提供一些保护,防止不良妊娠结局,而不会显著增加产后出血的风险。

试验注册

中国临床试验注册中心(ChiCTR);ChiCTR-OOC-16008203,回顾性注册日期:2016 年 4 月 1 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee8c/8607699/298d8201396b/12884_2021_4217_Fig1_HTML.jpg

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