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补充阿司匹林预防子痫前期对新生儿结局的影响。

Impact of Aspirin Supplementation for Pre-Eclampsia Prevention on Neonatal Outcomes.

作者信息

Campo Bertha, Fogel Joshua, Na Sean, Bryson Lennox

机构信息

Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY.

Department of Business Management, Brooklyn College, Brooklyn, NY.

出版信息

Kans J Med. 2023 Feb 21;16(1):41-47. doi: 10.17161/kjm.vol16.18138. eCollection 2023.

Abstract

INTRODUCTION

Pre-eclampsia negatively affects pregnancy. In 2018, the American College of Obstetricians and Gynecologists (ACOG) updated their low dose aspirin (LDA) supplementation recommendation to include pregnant women at moderate risk for pre-eclampsia. In addition to the potential benefit of LDA supplementation for delaying or preventing pre-eclampsia, LDA supplementation can affect neonatal outcomes. The association of LDA supplementation was studied with six neonatal outcomes in a sample of mostly minority pregnant women from Hispanic and Black race/ethnicities that included those of low, moderate, and high-risk designation for pre-eclampsia.

METHODS

This was a retrospective study of 634 patients. The main predictor variable was maternal LDA supplementation for six neonatal outcomes: NICU admission, neonatal readmission, one- and five-minute Apgar scores, neonatal birth weight (BW), and hospital length of stay (LOS). Demographics, comorbidities, and maternal high-or moderate-risk designation were adjusted for per ACOG guidelines.

RESULTS

High-risk designation was associated with neonatal increased rate of NICU admission (OR: 3.80, 95% CI: 2.02, 7.13, p < 0.001), LOS (B = 0.15, SE = 0.04, p < 0.001), and decreased BW (B = -442.10, SE = 75.07, p < 0.001). No significant associations were found with LDA supplementation or moderate-risk designation for NICU admission, readmission, low one- and five-minute Apgar scores, BW, and LOS.

CONCLUSIONS

Clinicians recommending maternal LDA supplementation should be aware that LDA supplementation did not appear to provide any benefits for the above neonatal outcomes.

摘要

引言

子痫前期会对妊娠产生负面影响。2018年,美国妇产科医师学会(ACOG)更新了其低剂量阿司匹林(LDA)补充剂的推荐,将子痫前期中度风险的孕妇纳入其中。除了LDA补充剂对延迟或预防子痫前期的潜在益处外,LDA补充剂还会影响新生儿结局。在一个主要为西班牙裔和黑人种族/族裔的少数族裔孕妇样本中,研究了LDA补充剂与六种新生儿结局之间的关联,这些孕妇包括子痫前期低、中、高风险的孕妇。

方法

这是一项对634例患者的回顾性研究。主要预测变量是母亲补充LDA对六种新生儿结局的影响:新生儿重症监护病房(NICU)入院、新生儿再次入院、1分钟和5分钟阿氏评分、新生儿出生体重(BW)和住院时间(LOS)。根据ACOG指南对人口统计学、合并症以及母亲的高风险或中度风险进行了调整。

结果

高风险与新生儿NICU入院率增加(OR:3.80,95%CI:2.02,7.13,p<0.001)、住院时间(B = 0.15,SE = 0.04,p<0.001)以及出生体重降低(B = -442.10,SE = 75.07,p<0.001)相关。在NICU入院、再次入院、1分钟和5分钟阿氏评分低、出生体重和住院时间方面,未发现补充LDA或中度风险与这些结局有显著关联。

结论

建议母亲补充LDA的临床医生应意识到,补充LDA似乎并未为上述新生儿结局带来任何益处。

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