对低剂量阿司匹林和怀孕期间出血并发症的倾向性评分分析
概括
低剂量阿司匹林 (LDA) 在怀孕期间使用,同时减少早产前,与更高的胎盘断裂和产后出血 (PPH) 风险有关. 除了高风险病例之外,在广泛推之前还需要进一步的研究.
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
- 在怀孕期间的药理学
背景情况:
- 低剂量阿司匹林 (LDA) 建议用于预防早产前.
- 有关LDA与怀孕期间出血并发症的关联存在担忧.
研究的目的:
- 评估怀孕期间胎盘断裂和产后出血 (PPH) 的风险,并推服用阿司匹林作为预防药物.
主要方法:
- 美国71,627例单子婴儿出生 (2019-2021) 的多中心队列研究.
- 倾向性评分权重被用于分析LDA建议和不良结果之间的关联.
- 排除标准包括胎盘前/,出生<24周怀孕,多胎妊娠和缺失的阿司匹林数据.
主要成果:
- 建议在9.3%的怀孕中使用LDA,更常见的是年长的母亲,BMI较高的母亲和先前存在的高血压患者.
- 使用LDA与胎盘断裂 (aOR 1.44) 和PPH (aOR 1.21) 的风险增加有关.
- 对于PPH来说,损害所需的数量是79,对于胎盘断裂则是287.
结论:
- 怀孕阿司匹林推与胎盘断裂和PPH的风险增加有关.
- 在提出更广泛的建议之前,需要对阿司匹林和出血风险进行更多研究.
- 目前对LDA的建议应仔细考虑,仅用于高风险怀孕.
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