摘要
目的系统性评价妊娠早中期服用阿司匹林对子痫前期高危人群的预防作用。方法全面检索Pub Med、Cochrane、OVID、web of science、Science Direct、EBSCO、Embase等英文数据库以及临床试验注册数据,纳入所有研究妊娠早中期服用阿司匹林对高危人群PE预防作用的相关文献,利用Revman 5.3软件对数据进行meta分析。结果最终纳入5个随机对照试验,860例受试者。结果显示,子痫前期高危人群妊娠16周前开始服用阿司匹林,妊娠期高血压发病风险(OR=0.35,95%CI 0.17-0.75,P=0.007)、子痫前期发病风险(OR=0.75,95%CI 0.47-0.98,P=0.04)、胎儿宫内生长受限发病风险(OR=0.53,95%CI 0.29-0.98,P=0.04)以及早产发病风险(OR=0.20,95%CI 0.08-0.48,P<0.001)均较对照组降低,且试验组较对照组新生儿平均出生体质量增加了107.15 g,差异有统计学意义(95%CI 76.13-138.18,P<0.001)。结论子痫前期高危人群妊娠16周前开始服用阿司匹林可降低妊娠期高血压、子痫前期发病风险、胎儿宫内生长受限、早产风险,提高新生儿出生体质量。
Objective To estimate the effect of early intervention with aspirin for prevention of preeclampsia in high- risk women. Methods A systematic review and meta- analysis were performed based on the principles and methods of Cochrane systematic reviews. Electronic databases were searched for randomized trials comparing aspirin with either placebo or no aspirin. Studies were included when meeting the inclusion criteria that the participants were pregnant women at a high risk of preeclampsia and started aspirin therapy at 16 gestational weeks or earlier, which were assessed by two independent reviewers. Meta- analysis was conducted using Review Manger 5.3 software. Results A total of 5 studies involving 860 participants were included in the final analysis. In the high-risk women, early use of aspirin showed an OR of 0.35（95%CI 0.17-0.75） for preventing pregnancy-induced hypertension（PIH）, 0.75（95%CI 0.47-0.98） for preeclampsia, 0.53（95%CI 0.29-0.98） for intrauterine growth retardation, and 0.20（95% CI 0.08-0.48） for preterm birth; the average birth weight in aspirin intervention group was 107.15 g（95% CI 76.13- 138.18, P〈0.001） more than that in the control group. Conclusion In high- risk pregnancies,early aspirin intervention starting before 16 weeks of gestation can prevent PIH, preeclampsia, IUGR, and preterm birth and help to increase the birth weight.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2015年第6期868-873,共6页
Journal of Southern Medical University
基金
国家自然科学基金(81471464)~~
