2018美国妇产科医师协会“妊娠期低剂量阿司匹林的应用”指南要点解读
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摘要
<正>阿司匹林是一种具有抗炎和抗血小板特性的环氧化酶抑制剂。妊娠期低剂量阿司匹林主要用于预防或推迟子痫前期(pre-eclampsia,PE)的发生,但其确切机制尚不清楚[1]。使用低剂量阿司匹林的其他适应证主要包括预防死产、胎儿生长受限、早产和早期流产等。近年来系统评价研究帮助产科医师对低剂量阿司匹林的使用有了更深层次的理解。然而,在产科临床实践中,低剂量阿司匹林的使用仍然缺
引文
[1]陈国庆,牛建民.阿司匹林预防子痫前期的相关问题[J].中国实用妇科与产科杂志,2018,33(7):688-691.
[2]De Berardis G,Lucisano G,D'Ettorre A,et al.Association of aspirin use with major bleeding in patients with and without diabetes[J].JAMA,2012,307:2286-2294.
[3]Duley L,Henderson-Smart DJ,Meher S,et al.Antiplatelet agents for preventing pre-eclampsia and its complications[J].Cochrane Database Syst Rev,2007,(2):CD004659.
[4]The Perinatal Antiplatelet Review of International Studies Collaboration Steering Group on behalf of the PC and The PC.Antiplatelet agents for prevention of pre-eclampsia and its consequences:a systematic review and individual patient data metaanalysis[J].BMC Pregnancy Childbirth,2005,5:7.
[5]Henderson JT,Whitlock EP,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,2014,160:695-703.
[6]Ahrens KA,Silver RM,Mumford SL,et al.Complications and safety of preconception low-dose aspirin among women with prior pregnancy losses[J].Obstet Gynecol,2016,127:689-698.
[7]Werler MM,Mitchell AA,Shapiro S.First trimester maternal medication use in relation to gastroschisis[J].Teratology,1992,45:361-367.
[8]Werler MM,Sheehan JE,Mitchell AA.Maternal medication use and risks of gastroschisis and small intestinal atresia[J].Am JEpidemiol,2002,155:26-31.
[9]Martinez-Frias ML,Rodriguez-Pinilla E,Prieto L.Prenatal exposure to salicylates and gastroschisis:a case-control study[J].Teratology,1997,56:241-243.
[10]Kozer E,Nikfar S,Costei A,et al.Aspirin consumption during the first trimester of pregnancy and congenital anomalies:a meta-analysis[J].Am J Obstet Gynecol,2002,87:1623-1630.
[11]Levin DL,Mills LJ,Parkey M,et al.Striction of the fetal ductus arteriosus after administration of indomethacin to the pregnant ewe[J].J Pediatr,1979,94:647-650.
[12]Coomarasamy A,Honest H,Papaioannou S,et al.Aspirin for prevention of preeclampsia in women with historical risk factors:a systematic review[J].Obstet Gynecol,2003,101:1319-1332.
[13]张芳,马玉燕.高血压患者孕前和孕期风险评估及处理[J].中国实用妇科与产科杂志,2017,33(3):253-256.
[14]Bujold E,Roberge S,Lacasse Y,et al.Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy:a meta-analysis[J].Obstet Gynecol,2010,116:402-414.
[15]Roberge S,Bujold E,Nicolaides KH.Aspirin for the prevention of preterm and term preeclampsia:systematic review and metaanalysis[J].Am J Obstet Gynecol,2018,218:287-293 e281.
[16]Roberge S,Nicolaides K,Demers S,et al.The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction:systematic review and meta-analysis[J].Am J Obstet Gynecol,2017,216:110-120 e116.
[17]Meher S,Duley L,Hunter K,et al.Antiplatelet therapy before or after 16 weeks'gestation for preventing preeclampsia:an individual participant data meta-analysis[J].Am J Obstet Gynecol,2017,216:121-128 e122.
[18]Narouze S,Benzon HT,Provenzano DA,et al.Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications:guidelines from the American Society of Regional Anesthesia and Pain Medicine,the European Society of Regional Anaesthesia and Pain Therapy,the American Academy of Pain Medicine,the International Neuromodulation Society,the North American Neuromodulation Society,and the World Institute of Pain[J].Reg Anesth Pain Med,2015,40:182-212.
[19]LeFevre ML,Force USPST.Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia:U.S.Preventive Services Task Force recommendation statement[J].Ann Intern Med,2014,161:819-826.
[20]Rai R,Backos M,Baxter N,et al.Recurrent miscarriage-an aspirin a day?[J].Hum Reprod,2000,15:2220-2223.
[21]Breeze AC,Lees CC.Poor obstetric outcome in subsequent pregnancies in women with prior fetal death[J].Obstet Gynecol,2005,105:445-446;author reply 446-447.
[22]Salafia CM,Minior VK,Pezzullo JC,et al.Intrauterine growth restriction in infants of less than thirty-two weeks'gestation:associated placental pathologic features[J].Am J Obstet Gynecol,1995,173:1049-1057.
[23]Roberge S,Giguere Y,Villa P,et al.Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia:a systematic review and meta-analysis[J].Am JPerinatol,2012,29:551-556.
[24]Wallenburg HC,Rotmans N.Prevention of recurrent idiopathic fetal growth retardation by low-dose aspirin and dipyridamole[J].Am J Obstet Gynecol,1987,157:1230-1235.
[25]Abramovici A,Cantu J,Jenkins SM.Tocolytic therapy for acute preterm labor[J].Obstet Gynecol Clin North Am,2012,39:77-87.
[26]Silver RM,Ahrens K,Wong LF,et al.Low-dose aspirin and preterm birth:a randomized controlled trial[J].Obstet Gynecol,2015,125:876-884.
[27]Empson M,Lassere M,Craig JC,et al.Recurrent pregnancy loss with antiphospholipid antibody:a systematic review of therapeutic trials[J].Obstet Gynecol,2002,99:135-144.
[28]Schisterman EF,Silver RM,Lesher LL,et al.Preconception low-dose aspirin and pregnancy outcomes:results from the EA-GeR randomised trial[J].Lancet,2014,384:29-36.2019-03-02
[2]De Berardis G,Lucisano G,D'Ettorre A,et al.Association of aspirin use with major bleeding in patients with and without diabetes[J].JAMA,2012,307:2286-2294.
[3]Duley L,Henderson-Smart DJ,Meher S,et al.Antiplatelet agents for preventing pre-eclampsia and its complications[J].Cochrane Database Syst Rev,2007,(2):CD004659.
[4]The Perinatal Antiplatelet Review of International Studies Collaboration Steering Group on behalf of the PC and The PC.Antiplatelet agents for prevention of pre-eclampsia and its consequences:a systematic review and individual patient data metaanalysis[J].BMC Pregnancy Childbirth,2005,5:7.
[5]Henderson JT,Whitlock EP,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,2014,160:695-703.
[6]Ahrens KA,Silver RM,Mumford SL,et al.Complications and safety of preconception low-dose aspirin among women with prior pregnancy losses[J].Obstet Gynecol,2016,127:689-698.
[7]Werler MM,Mitchell AA,Shapiro S.First trimester maternal medication use in relation to gastroschisis[J].Teratology,1992,45:361-367.
[8]Werler MM,Sheehan JE,Mitchell AA.Maternal medication use and risks of gastroschisis and small intestinal atresia[J].Am JEpidemiol,2002,155:26-31.
[9]Martinez-Frias ML,Rodriguez-Pinilla E,Prieto L.Prenatal exposure to salicylates and gastroschisis:a case-control study[J].Teratology,1997,56:241-243.
[10]Kozer E,Nikfar S,Costei A,et al.Aspirin consumption during the first trimester of pregnancy and congenital anomalies:a meta-analysis[J].Am J Obstet Gynecol,2002,87:1623-1630.
[11]Levin DL,Mills LJ,Parkey M,et al.Striction of the fetal ductus arteriosus after administration of indomethacin to the pregnant ewe[J].J Pediatr,1979,94:647-650.
[12]Coomarasamy A,Honest H,Papaioannou S,et al.Aspirin for prevention of preeclampsia in women with historical risk factors:a systematic review[J].Obstet Gynecol,2003,101:1319-1332.
[13]张芳,马玉燕.高血压患者孕前和孕期风险评估及处理[J].中国实用妇科与产科杂志,2017,33(3):253-256.
[14]Bujold E,Roberge S,Lacasse Y,et al.Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy:a meta-analysis[J].Obstet Gynecol,2010,116:402-414.
[15]Roberge S,Bujold E,Nicolaides KH.Aspirin for the prevention of preterm and term preeclampsia:systematic review and metaanalysis[J].Am J Obstet Gynecol,2018,218:287-293 e281.
[16]Roberge S,Nicolaides K,Demers S,et al.The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction:systematic review and meta-analysis[J].Am J Obstet Gynecol,2017,216:110-120 e116.
[17]Meher S,Duley L,Hunter K,et al.Antiplatelet therapy before or after 16 weeks'gestation for preventing preeclampsia:an individual participant data meta-analysis[J].Am J Obstet Gynecol,2017,216:121-128 e122.
[18]Narouze S,Benzon HT,Provenzano DA,et al.Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications:guidelines from the American Society of Regional Anesthesia and Pain Medicine,the European Society of Regional Anaesthesia and Pain Therapy,the American Academy of Pain Medicine,the International Neuromodulation Society,the North American Neuromodulation Society,and the World Institute of Pain[J].Reg Anesth Pain Med,2015,40:182-212.
[19]LeFevre ML,Force USPST.Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia:U.S.Preventive Services Task Force recommendation statement[J].Ann Intern Med,2014,161:819-826.
[20]Rai R,Backos M,Baxter N,et al.Recurrent miscarriage-an aspirin a day?[J].Hum Reprod,2000,15:2220-2223.
[21]Breeze AC,Lees CC.Poor obstetric outcome in subsequent pregnancies in women with prior fetal death[J].Obstet Gynecol,2005,105:445-446;author reply 446-447.
[22]Salafia CM,Minior VK,Pezzullo JC,et al.Intrauterine growth restriction in infants of less than thirty-two weeks'gestation:associated placental pathologic features[J].Am J Obstet Gynecol,1995,173:1049-1057.
[23]Roberge S,Giguere Y,Villa P,et al.Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia:a systematic review and meta-analysis[J].Am JPerinatol,2012,29:551-556.
[24]Wallenburg HC,Rotmans N.Prevention of recurrent idiopathic fetal growth retardation by low-dose aspirin and dipyridamole[J].Am J Obstet Gynecol,1987,157:1230-1235.
[25]Abramovici A,Cantu J,Jenkins SM.Tocolytic therapy for acute preterm labor[J].Obstet Gynecol Clin North Am,2012,39:77-87.
[26]Silver RM,Ahrens K,Wong LF,et al.Low-dose aspirin and preterm birth:a randomized controlled trial[J].Obstet Gynecol,2015,125:876-884.
[27]Empson M,Lassere M,Craig JC,et al.Recurrent pregnancy loss with antiphospholipid antibody:a systematic review of therapeutic trials[J].Obstet Gynecol,2002,99:135-144.
[28]Schisterman EF,Silver RM,Lesher LL,et al.Preconception low-dose aspirin and pregnancy outcomes:results from the EA-GeR randomised trial[J].Lancet,2014,384:29-36.2019-03-02