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衡水市妇幼保健院产科,河北 衡水 053000
副主任医师。研究方向:妊娠期常见病防治。 E-mail:shixiaoxia2001@163.com
主任医师。研究方向:妊娠期常见病防治。E-mail:739387256@qq.com
收稿:2025-02-24,
修回:2025-05-23,
录用:2025-05-26,
纸质出版:2025-11-15
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史晓霞,白艳,荣丽婷,等.不同日剂量阿司匹林预防子痫前期有效性和安全性的Meta分析 Δ[J].中国药房,2025,36(21):2733-2737.
SHI Xiaoxia,BAI Yan,RONG Liting,et al.Efficacy and safety of different daily doses of aspirin in prevention of preeclampsia:a meta-analysis[J].ZHONGGUO YAOFANG,2025,36(21):2733-2737.
史晓霞,白艳,荣丽婷,等.不同日剂量阿司匹林预防子痫前期有效性和安全性的Meta分析 Δ[J].中国药房,2025,36(21):2733-2737. DOI: 10.6039/j.issn.1001-0408.2025.21.20.
SHI Xiaoxia,BAI Yan,RONG Liting,et al.Efficacy and safety of different daily doses of aspirin in prevention of preeclampsia:a meta-analysis[J].ZHONGGUO YAOFANG,2025,36(21):2733-2737. DOI: 10.6039/j.issn.1001-0408.2025.21.20.
目的
2
比较不同日剂量阿司匹林预防子痫前期(PE)的有效性和安全性。
方法
2
检索PubMed、Medline、Embase、the Cochrane Library、中国知网、中国生物医学文献数据库、万方数据,收集阿司匹林日剂量≥100 mg(试验组)对比<100 mg(对照组)预防PE的回顾性病例对照研究和前瞻性随机对照试验,检索时限均为建库至2025年1月。筛选文献、提取数据和评价纳入文献质量后,采用RevMan 5.3软件进行Meta分析。
结果
2
共纳入11篇文献,共计3 052例妊娠期妇女。Meta分析结果显示,试验组妊娠期妇女的PE发生率[RR=0.63,95%CI(0.53,0.76),
P
<0.000 01
]
、妊娠期高血压发生率[RR=0.69,95%CI(0.50,0.94),
P
=0.02
]
、早产发生率[RR=0.56,95%CI(0.47,0.66),
P
<0.000 01
]
和胎儿生长受限发生率[RR=0.73,95%CI(0.61,0.87),
P
=0.000 5
]
均显著低于对照组;而两组产后出血发生率[RR=1.17,95%CI(0.90,1.53),
P
=0.25
]
比较,差异无统计学意义。亚组分析显示,使用阿司匹林150 mg中国妊娠期妇女的PE发生率显著高于使用阿司匹林100 mg者[RR=3.40,95%CI(1.29,8.93),
P
=0.01
]
;而二者产后出血发生率、早产发生率比较,差异均无统计学意义(
P
>0.05)。
结论
2
与阿司匹林日剂量<100 mg比较,阿司匹林日剂量≥100 mg预防PE的有效性更优,妊娠期高血压发生率、早产发生率、胎儿生长受限发生率更低,且不会增加妊娠期妇女产后出血的发生风险;对于中国妊娠期妇女而言,100 mg的阿司匹林日剂量预防PE的有效性可能优于150 mg。
OBJECTIVE
2
To compare the efficacy and safety of different daily doses of aspirin in the prevention of preeclampsia (PE).
METHODS
2
The case-control studies and prospective randomized controlled trials on aspirin with daily dose ≥ 100 mg (trial group) vs. <100 mg (control group) in the prevention of PE were retrieved from PubMed, Medline, Embase, the Cochrane Library, CNKI, China Biomedical Literatue Database and Wanfang Data from base-building to January 2025. After literature screening, data extraction and quality evaluation, meta-analysis was performed by using RevMan 5.3 software.
RESULTS
2
A total of 11 literatures were included, involving 3 052 pregnant women. Meta-analysis showed the incidence of PE [RR=0.63, 95%CI (0.53,0.76),
P
<0.000 01
]
, gestational hypertension [RR=0.69, 95%CI (0.50,0.94),
P
=0.02
]
, preterm birth [RR=0.56, 95%CI (0.47,0.66),
P
<0.000 01
]
, and intrauterine growth retardation [RR=0.73,95%CI (0.61,0.87),
P
=0.000 5
]
in trial groups were significantly lower than control group. The incidence of postpartum hemorrhage between the two groups had no statistically significant difference [RR=1.17, 95%CI (0.90,1.53),
P
=0.25
]
. Subgroup analysis showed that the incidence of PE in Chinese pregnant women taking 150 mg of aspirin was significantly higher than taking 100 mg of aspirin [RR=3.40, 95%CI (1.29, 8.93),
P
=0.01
]
; but there was no significant difference between the two groups in the incidences of postpartum hemorrhage, preterm birth (
P
>0.05).
CONCLUSIONS
2
Aspirin with daily dose ≥100 mg is more effective in preventing PE than daily dose <100 mg, with lower rates of gestational hypertension, preterm birth, and intrauterine growth retardation. It does not increase the risk of postpartum hemorrhage. For pregnant women in China, daily dose 100 mg of aspirin may be more effective in preventing PE than 150 mg.
中华医学会妇产科学分会妊娠期高血压疾病学组 . 妊娠期高血压疾病诊治指南:2020 [J ] . 中华妇产科杂志 , 2020 , 55 ( 4 ): 227 - 238 .
ROBERGE S , BUJOLD E , NICOLAIDES K H . Aspirin for the prevention of preterm and term preeclampsia:systematic review and metaanalysis [J ] . Am J Obstet Gynecol , 2018 , 218 ( 3 ): 287 - 293.e1 .
CLUVER C , KUPKA E , HESSELMAN S , et al . Compa- ring aspirin 75 to 81 mg vs 150 to 162 mg for prevention of preterm preeclampsia:systematic review and meta-analysis:questionable quality and small study effects [J ] . Am J Obstet Gynecol MFM , 2023 , 5 ( 10 ): 101098 .
杨锐 , 黄仁瑛 , 谌伦华 . 阿司匹林对子痫前期及早产影响的Meta分析 [J ] . 重庆医学 , 2022 , 51 ( 3 ): 479 - 484,490 .
STANG A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses [J ] . Eur J Epidemiol , 2010 , 25 ( 9 ): 603 - 605 .
JADAD A R , MOORE R A , CARROLL D , et al . Asses- sing the quality of reports of randomized clinical trials:is blinding necessary? [J ] . Control Clin Trials , 1996 , 17 ( 1 ): 1 - 12 .
CHAMANI M , SHAHRABI S , MALMIR A , et al . Effect of aspirin dose on preeclampsia prevention and fetal-maternal complications:a randomized clinical trial [J ] . Jundishapur J Chronic Dis Care , 2021 , 11 ( 1 ): e114112 .
AMRO F H , BLACKWELL S C , PEDROZA C , et al . Aspirin 162 mg vs 81 mg for preeclampsia prophylaxis in high-risk obese individuals:a comparative effectiveness open-label randomized trial (ASPREO) [J ] . Am J Obstet Gynecol , 2025 , 232 ( 3 ): 315.e1 - 315.e8 .
AYYASH M , GOYERT G , GARCIA R , et al . Efficacy and safety of aspirin 162 mg for preeclampsia prophylaxis in high-risk patients [J ] . Am J Perinatol , 2024 , 41 ( Suppl. 1 ): e2410 - e2417 .
KASRAEIAN M , ASADI N , VAFAEI H , et al . The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women [J ] . J Perinat Med , 2022 , 50 ( 9 ): 1264 - 1270 .
KUMAR N , DAS V , AGARWAL A , et al . Pilot interventional study comparing fetomaternal outcomes of 150 mg versus 75 mg aspirin starting between 11 and 14 weeks of pregnancy in patients with high risk of preeclampsia:a randomized control trial [J ] . J Obstet Gynaecol India , 2020 , 70 ( 1 ): 23 - 29 .
SINHA N , SINGH S , AGARWAL M , et al . A randomized controlled study comparing the efficacy of 75 mg versus 150 mg aspirin for the prevention of preeclampsia in high-risk pregnant women [J ] . Cureus , 2023 , 15 ( 5 ): e39752 .
ZORZATO P , TORCIA E , CARLIN A , et al . Comparison of two aspirin doses for the prophylaxis of preeclampsia in twin pregnancy:a multicentre retrospective study with propensity score matching [J ] . Am J Obstet Gynecol , 2025 , 233 ( 1 ): 55.e1 - 55.e10 .
TAPP S , GUERBY P , GIRARD M , et al . A pilot rando- mized trial comparing the effects of 80 versus 160 mg of aspirin on midtrimester uterine artery pulsatility index in women with a history of preeclampsia [J ] . J Obstet Gynaecol Can , 2020 , 42 ( 12 ): 1498 - 1504 .
何续芳 , 万艳 , 郭艳阳 , 等 . 不同剂量阿司匹林联合复合维生素片在子痫前期高危孕妇中的预防效果及安全性研究 [J ] . 川北医学院学报 , 2024 , 39 ( 4 ): 498 - 501,510 .
朱云花 , 蒋玲玲 , 宁玲利 . 低剂量阿司匹林对高危孕妇子痫前期的预防效果 [J ] . 中国妇幼健康研究 , 2015 , 26 ( 2 ): 295 - 297 .
舒俊俊 , 龚丹 , 杨云华 . 不同剂量阿司匹林预防子痫前期的临床效果比较及对妊娠结局的影响 [J ] . 中国现代医生 , 2020 , 58 ( 36 ): 20 - 22,27 .
JONES PULLINS M E , BOGGESS K A . Aspirin dosage for preeclampsia prophylaxis:an argument for 162-mg dosing [J ] . Am J Obstet Gynecol MFM , 2025 , 7 ( Suppl.1 ): 101620 .
VINOGRADOV R , KAVANAGH O N , PALMER J , et al . A randomized crossover design study comparing the pharmacokinetics and pharmacodynamics of 2 single doses of oral aspirin (75 mg vs 150 mg) in pregnant women at risk of preeclampsia:implications on assessing aspirin response and patient adherence to therapy [J ] . Am J Obstet Gynecol , 2025 , 232 ( 5 ): 474.e1 - 474.e15 .
CARON N , RIVARD G É , MICHON N , et al . Low-dose ASA response using the PFA-100 in women with high-risk pregnancy [J ] . J Obstet Gynaecol Can , 2009 , 31 ( 11 ): 1022 - 1027 .
王星语 , 张美玲 , 张师前 . 不同剂量阿司匹林对子痫前期预防作用的Meta分析 [J/OL ] . 妇产与遗传 (电子版), 2022 , 12 ( 2 ): 1 - 9 [ 2025-01-20 ] . https://www.cnki.com.cn/Article/CJFDTotal-FCYC202202001. htm https://www.cnki.com.cn/Article/CJFDTotal-FCYC202202001.htm . DOI: 10.3868/j.issn.2095-1558.2022.02.001 http://dx.doi.org/10.3868/j.issn.2095-1558.2022.02.001 .
HENDERSON J T , WHITLOCK E P , O’CONNOR E , et al . Low-dose aspirin for prevention of morbidity and mortality from preeclampsia:a systematic evidence review for the U.S. preventive services task force [J ] . Ann Intern Med , 2014 , 160 ( 10 ): 695 - 703 .
FINNERAN M M , GONZALEZ-BROWN V M , SMITH D D , et al . Obesity and laboratory aspirin resistance in high-risk pregnant women treated with low-dose aspirin [J ] . Am J Obstet Gynecol , 2019 , 220 ( 4 ): 385.e1 - 385.e6 .
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