Department of Obstetrics and Gynecology, Henry Ford Health, Detroit, Michigan.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Henry Ford Health, Detroit, Michigan.
Am J Perinatol. 2024 May;41(S 01):e2410-e2417. doi: 10.1055/s-0043-1771260. Epub 2023 Jul 29.
The aim of this study was to compare the safety and efficacy of aspirin 162 mg to the standard recommended dose of 81 mg for preeclampsia prevention.
A retrospective cohort study of patients at risk for preeclampsia who delivered between January 2013 and December 2020 at Henry Ford Health was performed. Patients were divided into three groups: a no aspirin group, a group treated under an 81 mg aspirin preeclampsia prophylaxis protocol, and a group treated under a 162 mg protocol. Univariate and multivariable logistic regression analyses compared rates of preeclampsia and secondary outcomes between groups. Clinical side effects traditionally associated with aspirin use were also assessed.
Of 3,597 patients, 2,266 (63%) were in the no aspirin group, 944 (26%) were in the 81 mg group, and 387 (11%) were in the 162 mg group. The rate of preeclampsia was significantly lower in the 162 mg group (10.1%, odds ratio, 0.68; 95% confidence interval, 0.46-0.99) compared with the 81 mg group (14.2%). The rate of preeclampsia was identical in the no aspirin and 81 mg groups. The rate for postpartum hemorrhage, postpartum hematoma, and intraventricular hemorrhage of the newborn were not significantly different between patients in the 162 and 81 mg groups.
We observed a significantly lower rate of preeclampsia in high-risk patients who were treated with the 162 mg dose of aspirin for preeclampsia prophylaxis, and bleeding complications were not seen with the higher dose. Our study suggests that aspirin 162 mg may be considered for prophylaxis in patients at high risk for preeclampsia.
· Aspirin 81 mg is currently standard for preeclampsia prophylaxis.. · Preeclampsia rate is significantly lower among high-risk patients taking aspirin 162 mg compared with 81 mg.. · Bleeding complications are not increased among those taking aspirin 162 mg..
本研究旨在比较 162mg 阿司匹林用于子痫前期预防的安全性和疗效，与标准推荐剂量 81mg 阿司匹林相比。
对 2013 年 1 月至 2020 年 12 月在亨利福特健康中心分娩的子痫前期高危患者进行回顾性队列研究。患者分为三组：未用阿司匹林组、81mg 阿司匹林子痫前期预防方案组和 162mg 方案组。采用单变量和多变量逻辑回归分析比较各组子痫前期发生率和次要结局。还评估了传统上与阿司匹林使用相关的临床副作用。
在 3597 名患者中，2266 名（63%）患者未用阿司匹林，944 名（26%）患者使用 81mg 阿司匹林，387 名（11%）患者使用 162mg 阿司匹林。与 81mg 组（14.2%）相比，162mg 组子痫前期发生率显著降低（10.1%，比值比，0.68；95%置信区间，0.46-0.99）。未用阿司匹林组和 81mg 组的子痫前期发生率相同。162mg 和 81mg 组患者的产后出血、产后血肿和新生儿脑室内出血发生率无显著差异。
我们观察到，高危患者使用 162mg 阿司匹林进行子痫前期预防，子痫前期发生率显著降低，且高剂量无出血并发症。我们的研究表明，162mg 阿司匹林可能被认为是子痫前期高危患者的预防药物。
