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[小剂量阿司匹林预防子痫前期的重要考量]

[Important Considerations of Low-Dose Aspirin in the Prevention of Preeclampsia].

作者信息

Wang Jing, Shen Li-Xia, Wang Zi-Lian, Liona C Poon

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Department of Obstetrics and Gynecology, Chinese University of Hong Kong, Hong Kong 999077, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):450-454. doi: 10.12182/20230360207.

Abstract

Low-dose prophylactic aspirin is widely recommended for pregnant women for the prevention of preeclampsia (PE). Although the efficacy of aspirin in preventing PE has been evaluated in many studies, due to the differences in dosage, initiation time, and screening methods for the identification of women at high risk of PE and the lack of a uniform opinion on the medication regimen of aspirin, currently in China there is no consensus on the standardized treatment scheme of aspirin for the prevention of PE in clinical guidelines. Herein, we reviewed the current available evidence and the recommendations of clinical guidelines concerning the controversies about aspirin dosage as well as the timing of starting and stopping aspirin, so as to provide further guidance for clinical practice. Based on the existing research findings on and clinical practice of using aspirin for PE prevention, we suggested that PE risk screening should be conducted at 11-13 weeks of gestation. In addition, the recommended dose for prophylactic use of aspirin for pregnant women at high risk of PE is 150 mg/d, and the recommended minimum effective dose is 100 mg/d. Pregnant women at high risk of PE should start taking low-dose aspirin orally before 16 weeks of pregnancy. Week 36 of gestation is considered the window of opportunity for discontinuation of low-dose aspirin.

摘要

低剂量预防性阿司匹林被广泛推荐用于孕妇预防子痫前期(PE)。尽管阿司匹林预防PE的疗效已在许多研究中得到评估,但由于PE高危女性的剂量、起始时间、筛查方法存在差异,且对于阿司匹林用药方案缺乏统一意见,目前在中国临床指南中对于阿司匹林预防PE的标准化治疗方案尚无共识。在此,我们回顾了当前关于阿司匹林剂量以及起始和停用时间争议的现有证据和临床指南建议,以便为临床实践提供进一步指导。基于现有关于使用阿司匹林预防PE的研究结果和临床实践,我们建议在妊娠11 - 13周进行PE风险筛查。此外,PE高危孕妇预防性使用阿司匹林的推荐剂量为150mg/d,推荐最小有效剂量为100mg/d。PE高危孕妇应在妊娠16周前开始口服低剂量阿司匹林。妊娠36周被认为是停用低剂量阿司匹林的时机窗。

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[Preeclampsia: An Obstetrician's Perspective].[子痫前期:产科医生的视角]
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Nov;53(6):1003-1006. doi: 10.12182/20221160203.
3
Low-Dose Aspirin for the Prevention of Preeclampsia.小剂量阿司匹林预防子痫前期
JAMA. 2021 Sep 28;326(12):1153-1155. doi: 10.1001/jama.2021.14646.

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