在更新了关于孕前的社会人口风险因素指南后,低剂量阿司匹林使用的变化
Taylor S Freret1, Allison S Bryant1, Kaitlyn E James1
1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, the Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts; and the Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida.
O&G open
|September 26, 2025
概括
新的指导方针增加了黑人患者的低剂量阿司匹林使用,但不是那些有公共保险的患者. 尽管更新了建议,但总体使用量仍然很低.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 孕前是孕产妇发病率和死亡率的一个重要原因.
- 美国预防服务工作组 (USPSTF) 和美国妇产科医生学院 (ACOG) 在2021年最新的指南更新中将种族和收入作为风险因素.
- 这些更新旨在解决孕前发病率和结果的差异.
研究的目的:
- 评估2021年USPSTF和ACOG指南修改对黑人患者和低收入患者 (由医疗补助保险代理) 中低剂量阿司匹林使用的影响.
- 评估这些指导方针的变化是否有效地增加了在确定的风险人群中预防性低剂量阿司匹林的吸收.
主要方法:
- 在单一医疗保健系统内,对从2017年到2022年分娩的无产妇患者进行了重复的横截面分析.
- 建立了两个匹配的队列:一个按种族分层 (黑人与白人),另一个按保险状况分层 (医疗补助与私人).
- 使用差异差异分析来比较2021年指南变化之前和之后的低剂量阿司匹林使用率.
主要成果:
- 这项研究包括超过31,000名跨种族和收入队列的参与者.
- 与白人患者相比,黑人患者的低剂量阿司匹林使用量增加了8.8个百分点.
- 与私人保险相比,在医疗补助保险患者中没有观察到低剂量阿司匹林使用的显著增加.
结论:
- 2021年USPSTF和ACOG指南与黑人患者低剂量阿司匹林使用的增加有关,这表明对解决种族不平等有积极影响.
- 然而,这些指导方针并没有导致公共保险患者低剂量阿司匹林使用的同样增加.
- 尽管有指导方针更新,但低剂量阿司匹林用于预防产前的总体使用率仍然低于最佳水平.
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