アスピリンの推奨ガイドライン後の米国における早産の傾向
Mariam K Ayyash1, Huda B Al-Kouatly2, Majid Shaman3
1Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, NY, NY, USA.
Journal of the National Medical Association
|August 23, 2025
まとめ
米国予防サービスタスクフォース (USPSTF) は,早産 (PTB) を防ぐためにアスピリンの使用を推奨しました. 調整された分析では,PTBがわずかに減少していることが示されたが,観測された傾向は,ガイドラインの実施後に明らかな減少を示さなかった.
科学分野:
- 産婦人科
- 妊婦と胎児の医療
- 公衆衛生
背景:
- 産前出産 (PTB) は米国では依然として大きな課題です.
- 米国予防サービスタスクフォース (USPSTF) は,PTB予防のために低用量アスピリンを推奨するガイドラインを発行した.
- これらのガイドラインが国内における PTB 率に与える現実の影響を評価することは極めて重要です.
研究 の 目的:
- USPSTFのアスピリンの推奨に従って,米国における全体的な早産率の変化を評価する.
- ガイドライン以前のデータに基づいて観測されたPTB傾向と予測された傾向を比較する.
主な方法:
- 米国の出生データベース (2010年−2014年および2016年−2021年) を利用した遡及コホート研究.
- 2015年からのデータを除外 (ガイドラインの公表年)
- 単変数および多変数解析を用いて,アスピリン前およびアスピリン後グループ間の早産率 (<37週および<34週) の比較.
主要な成果:
- この研究ではアスピリン投与前のグループで 1200万件以上,アスピリン投与後のグループで 1760万件以上の出産を分析した.
- アスピリン投与後の期間に,調整された分析により,PTB率のわずかな低下 (< 37週間: aOR 0. 940, < 34週間: aOR 0. 920) が示されました.
- 観測されたPTBの動向は,2021年まで予測された動向を反映した.
結論:
- USPSTFのアスピリンに関するガイドラインは,PTBの減少に潜在的にわずかな利点があることを示唆しています.
- しかし,アスピリンに関するガイドラインの実施に伴い,PTB率の観測された国内動向は,明確で持続的な減少を示さなかった.
- PTBの発生率とガイドラインの有効性に影響を与える複雑な要因を理解するには,さらなる研究が必要かもしれません.
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