在阿司匹林推后,美国的早产趋势
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
概括
美国预防服务工作组 (USPSTF) 建议使用阿司匹林来预防早产. 虽然调整后的分析显示PTB有所减少,但观察到的趋势并未证实在实施指南后明显下降.
科学领域:
- 产科和妇科
- 产妇和胎儿医学
- 公共卫生
背景情况:
- 在美国,早产仍然是一个重大挑战.
- 美国预防服务工作组 (USPSTF) 发布了推低剂量阿司匹林预防PTB的指导方针.
- 评估这些指南对国家PTB率的实际影响至关重要.
研究的目的:
- 根据USPSTF对阿司匹林的建议,评估美国总体和早期早产率的变化.
- 将观察到的PTB趋势与基于指南前数据的预测趋势进行比较.
主要方法:
- 使用美国出生数据库 (2010-2014年和2016-2021年) 的回顾性队列研究.
- 不包括2015年的数据 (指南公布年份).
- 使用单变量和多变量分析对前阿司匹林组和后阿司匹林组的早产率 (<37周和<34周) 的比较.
主要成果:
- 这项研究分析了阿司匹林前组的1200多万名新生儿和阿司匹林后组的1760万名新生儿.
- 在阿司匹林后期,调整后的分析显示PTB发病率略有下降 (< 37周: aOR 0. 940; < 34周: aOR 0. 920).
- 观察到的PTB趋势反映了到2021年的预测趋势,当时的利率开始超过预测.
结论:
- 经过调整的统计分析表明,USPSTF对阿司匹林的指导方针在减少PTB方面可能具有适度的益处.
- 然而,在实施阿司匹林指南后,观察到的PTB病例的全国趋势并没有显示出明显的持续下降.
- 可能需要进一步的研究来了解影响PTB率和指南有效性的复杂因素.
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