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Updated: Feb 13, 2026

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为什么低剂量阿司匹林在没有APS的重复妊娠流产中持续存在:认知偏差和系统设计

Kentaro Iga^1,2, Takeshi Murakoshi¹, Hiroshi Adachi¹

¹Division of Perinatology, Fetal Diagnosis and Therapy, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan (Iga, Murakoshi, and Adachi).

AJOG global reports

|February 12, 2026

概括

低剂量阿司匹林 (LDA) 经常被处方用于复发性流产 (RPL),但没有证据表明有好处. 认知偏见和医疗保健系统因素使其使用延续,强调需要在生殖医学中以证据为基础的实践.

科学领域:

生殖医学生殖医学
医学心理学医学心理学
医疗保健服务研究医疗服务研究

背景情况:

低剂量阿司匹林 (LDA) 经常被处方用于复发性流产 (RPL),即使没有抗脂综合征 (APS).
高级证据表明,在这些情况下,LDA并没有改善活产率,但其经验性使用在全球范围内仍然存在.
这种持续使用表明,问题源于行为和系统因素,而不仅仅是缺乏证据.

研究的目的:

通过认知偏见和机构设计的镜头来解释LDA对RPL的持续实证使用.
为了确定心理和系统机制,尽管有矛盾的证据,维持使用LDA.
建议采取对策,使基于证据的实践与生殖医学中的患者护理保持一致.

主要方法:

评论分析了LDA使用的持久性,通过检查诸如动作偏差,可用性启发式和损失厌恶等认知偏差.
它还研究了系统因素,包括医疗补偿结构,专业合规性和护理中断.
作者利用现有的文献和临床观察来在生殖医学环境中解决这些问题.

主要成果:

像动作偏差和可用性启发式启发式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式启动式.
机构因素,包括补偿政策和缺乏护理连续性的因素,加强了LDA的使用.
这些因素结合起来,为LDA创造了一个自我强化的默认状态,将无证据的干预转变为标准实践.

结论:

在RPL中经验性LDA使用是一个复杂的现象,是由心理和系统因素驱动的,而不是个人错误.
应对措施应包括偏见教育,对LDA使用的明确标准 (例如,仅用于已确认的APS),以及共享决策工具.
重新设计护理环境以促进基于证据的克制和护理的连续性对于在生殖医学中协调科学和同情至关重要.

关键词:

抗脂综合征是一种抗脂综合征.认知偏见是一种认知偏见.伦理学伦理伦理学低剂量阿司匹林的使用.经常发生的流产.生殖医学是一种生殖医学.这是治疗幻觉.

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