Low-dose Aspirin For Preeclampsia Prevention In High-risk Pregnancy

Preeclampsia and its associated morbidity and mortality remain major public health concerns worldwide.The main clinical manifestation are hypertension and proteinuria after 20 gestational weeks,often involving multiple organs such as heart,brain,liver and kidney,which seriously threaten the maternal health.The pathogenesis of preeclampsia has not been fully elucidated,but it is shown to be related to heredity,immunity,and inflammation of blood vessels.As an anti-platelet aggregation drug,aspirin has been studied extensively in preeclampsia,but there is no consensus on its usage and dosage in clinical practice.Objective:To explore the effect of low-dose aspirin on preeclampsia prevention in high-risk pregnant women.Object and method:Singleton pregnant women who set up maternal and child health handbook and done routine perinatal health care in the third affiliated hospital of Zhengzhou university from October 2016 to October 2017 are the research object.According to inclusion and exclusion criteria,choosing 0-20 weeks(checked with the gestational age)eligible high-risk pregnant women into groups,and divided by random number table into trial group(group A)and control group(group B).Among them,94 people in the experimental group and 85 in the control group.The trial group(group A)administered aspirin 100mg/d oral before sleeping in the 12-20 weeks of gestation and stopped at 34 gestational weeks,while the control group(group B)was a blank control group,and the pregnant women were followed-up regularly to postpartum.During our research,blood and urine routine,liver and kidney function,coagulation function,obstetric ultrasound will be detected and recorded in every perinatal care stage.General physical examination and routine physical examination were also performed.The study was reviewed and approved by the ethics committee and all clinical subjects followed the voluntary principle and signed informed consent.Results:1.The experimental group(n=94)and the control group(n=85)of pregnant women were all ethnic han.There was no statistically significant difference(P>0.05)about age,gravidity and parity history,pregestational BMI,education,occupation and household income per capita between the two groups.2.Indexes of liver function(ALT,AST,albumin,TBIL,DBIL);related indicators of renal function(urea,creatinine,uric acid);the coagulation function(PT,APTT,FIB,INR,D-Di)in two groups in the third trimester showed no statistical difference(P>0.05).3.There were statistically significant difference between the two groups about delivery gestational age(37.46±2.71 vs 36.18±2.84),neonatal weight(2855±655 vs2603±822),premature birth(21.3%vs 38.8%),extremely low birth weight(5.3%vs14.1%).However,1min Apgar score(9.44±1.17 vs 9.32±1.19),5min Apgar score(9.70±0.79 vs 9.64±0.71),and neonatal asphyxia probability(8.5%vs 12.9%)was not statistically significant(P>0.05).4.The difference of incidence rate of preeclampsia(13.8%vs 27.0%)between two groups was statistically significant(P<0.05),but the incidence rate of placental abruption,HELLP syndrome,hydrothorax and ascites between the two groups were not statistical difference(P>0.05).5.The occurrence time of preeclampsia was observed.The preeclampsia occurrence time in trial group is significantly posterior to the control group,the difference was statistically significant(?~2=9.049,P=9.049).Conclusions:1.Taking low-dose aspirin between 12-20 weeks has a certain preventive effect for high-risk pregnant women of preeclampsia,can reduce the incidence of preeclampsia,delay the onset time of preeclampsia and improve pregnancy outcomes.2.Taking aspirin during pregnancy does not increase the risk of liver and kidney damage and abnormal coagulation in the third trimester.