预防子宫前的抗血小板药物:对个体患者数据的元分析
Lisa M Askie1, Lelia Duley2, David J Henderson-Smart3
1Centre for Perinatal Health Services Research, University of Sydney, Sydney, Australia; NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia; UK Cochrane Centre, Oxford, UK.
Lancet (London, England)
|May 22, 2007
概括
低剂量阿司匹林和其他抗血小板药物可以适度降低孕妇产前和早产的风险. 这些代理商提供一致的好处,而无需确定最受益的特定子组.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 孕前是导致母亲和婴儿死亡率和发病率的主要原因.
- 抗血小板药物,特别是低剂量阿司匹林,正在研究预防先兆子.
- 了解初级预防的最佳使用是至关重要的.
研究的目的:
- 评估抗血小板药物用于预防先兆子的初级预防.
- 确定可能从这种干预中受益最多的患者子组.
主要方法:
- 进行了对个别患者数据的元分析.
- 分析了31项随机试验的数据,其中包括32,217名妇女和32,819名婴儿.
- 专注于对子宫前的初级预防.
主要成果:
- 抗血小板药物显示,孕前的相对风险减少了10% (RR 0.90;95% CI 0.84-0.97).
- 在怀孕34周前分娩的风险减少了10% (RR 0.90;95% CI 0.83-0.98).
- 严重的不良妊娠结果减少了10% (RR 0.90;95% CI 0.85-0.96).
- 没有发现对胎儿/新生儿死亡,对于妊娠年龄的婴儿来说小,或出血事件的显著影响.
- 没有一个特定的子组表现出明显更大或更小的好处.
结论:
- 抗血小板药物始终降低了怀孕期间子宫前的相对风险.
- 这些药物与怀孕34周之前早产的适度但持续减少有关.
- 观察到严重不良妊娠结果的适度但持续减少.
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