小剂量阿司匹林在预防有早产史患者早产中的作用

Journal of Rawalpindi Medical College Pub Date : 2023-09-26 DOI:10.37939/jrmc.v27i3.2363

Maliha Sadaf, Aasia Saleem, Tallat Farkhanda, Khansa Iqbal, Sabeen Ashraf, Amna Iftikhar

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引用次数: 0

摘要

目的：早产（PTB）发生在妊娠 24-37 周之间。早产的重要风险因素是曾发生过早产，目前黄体酮被用于治疗复发性自发性早产。一些研究显示了良好的结果，但最近的研究显示，阴道黄体酮的使用与 PTB 可能性的降低或新生儿不良反应无关。因此，文献中的争议表明，PTB 的进展涉及多种潜在病理机制。本研究旨在确定小剂量阿司匹林在既往有早产史的患者中预防早产的作用。研究方法在这项随机对照试验中，从住院部和门诊部共选取了 172 名符合纳入标准的患者。使用随机数字表将患者随机分为两组（A 组和 B 组）。A 组给予低剂量阿司匹林（75 毫克），B 组为对照组。门诊部每 8 周召集一次患者，以评估其服药依从性和副作用。数据使用 SPSS v25.0 进行输入和分析。采用卡方（Chi-square）对两组患者的早产发生率进行比较。计算了使用阿司匹林后早产发生率下降的相对风险（以及 95% 的置信区间）。研究结果参与研究的人员年龄在 18 至 40 岁之间。A 组患者的平均年龄为（33.85±5.210）岁，B 组患者的平均年龄为（32.86±4.139）岁。A 组胎儿出生体重平均为（2281.1962±363.125）克，B 组胎儿出生体重平均为（2271.4344±374.797）克。低剂量阿司匹林组有 10 例（11.6%）早产，对照组有 31 例（36.0%）早产，P 值为 0.001，具有统计学意义。服用低剂量阿司匹林的早产风险是对照组的 1.801 倍。结论：与对照组相比，在妊娠 14 周前服用小剂量阿司匹林可降低曾有过早产史的妇女自然早产的风险。

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Role Of Low Dose Aspirin In Preventing Preterm Birth In Patients With Previous History Of Preterm Delivery

Objective: Preterm birth (PTB) occurs between 24-37 weeks of gestation. The important risk factor for PTB is a previous PTB and currently progesterone is used for the management of recurrent spontaneous PTB. Some studies have shown good outcomes but recent studies revealed that the use of vaginal progesterone was not related to a decreased likelihood of PTB or neonatal adverse effects. Thus, the controversy in the literature suggests multiple underlying pathological mechanisms involved in the progression of PTB. This study aims to determine the role of low-dose aspirin in the prevention of preterm birth in patients with a previous history of preterm delivery. Methodology: In this randomized controlled trial, a total of 172 patients fulfilling the inclusion criteria were selected from the inpatient and outpatient departments. Patients were divided randomly into two groups (group A and group B), using random number tables. In Group A, low-dose aspirin (75mg) was given while group B was taken as a control group. Patients were called every 8 weeks in the outpatient department for the assessment of compliance and side effects of the drug. The data were entered and analyzed by using SPSS v25.0. Chi-square was used to compare the two groups for incidence of preterm birth. Relative risk (along with a 95% confidence interval) for the decrease in the incidence of preterm birth with the use of aspirin was calculated. Results: The age of participants included in the study was 18 to 40 years. The mean age of patients in group A was 33.85±5.210 years and in group B was 32.86±4.139 years. The mean fetal birth weight in group A was 2281.1962±363.125 grams and in group B was 2271.4344±374.797 grams. In the low-dose aspirin group, 10(11.6%) had preterm birth and 31(36.0%) in the control group with a p-value of 0.001, which is statistically significant. The risk of having preterm birth with low-dose aspirin was 1.801 times less than controls. Conclusion: aspirin in low dose given before 14 weeks of gestation decrease spontaneous preterm birth as compared to the control group in a woman with a history of previous preterm birth which was spontaneous

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Journal of Rawalpindi Medical College

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24 weeks