Effects Of Low-dose Aspirin Therapy From 11-20 Weeks Of Gestation On Pregnancy Outcome In Patient Women With Chronic Hypertension

Objective:To investigate the effect of oral low-dose aspirin from 11-20 weeks of gestationon pregnancy outcome in patients with chronic hypertension.Methods:A retrospective cohort study was conducted to collect a total of 416 pregnant women with chronic hypertension who received obstetric care and gave birth in the First Affiliated Hospital of Kunming Medical University and the Alliance Hospital--Kunming Angel Women's and Children's Hospital from January 2013 to December 2019.Among them,204 patients who did not take aspirin orally during pregnancy were in the non-intervention group.A total of 212 patients with oral aspirin during pregnancy were included in the total intervention group.A total of 90 patients took aspirin at a dose of 75mg every day,and were set as the intervention group 75mg.A total of 72 patients taking aspirin at a dose of 100mg every day were assigned to the intervention group 100mg.A total of 50 patients taking aspirin at a dose of 150mg every day were assigned to the intervention group 150mg.Demographic parameters,incidence of chronic hypertension complicated with PE,and other pregnancy and neonatal outcomes were compared between the non-intervention group and the total intervention group,and the non-intervention group and the intervention group respectively between 75mg,100mg,and150mg.Results:1.The total prevalence rate of pregnancy complicated with chronic hypertension during the seven-year study period was 1.16%,with an increasing trend year by year(RS=0.952,P<0.05).2.In the total intervention group,the incidence of PE[30.2%VS73.0%,P<0.05,OR:0.412(95%CI:0.330-0.514)],PE with early onset(<34 weeks)[7.5%VS48.5%,P<0.05,OR:0.214(95%CI:0.135-0.339)]and PE with pre-term(<37 weeks)[18.9%VS58.8%,P<0.05,OR:0.372(95%CI:0.281-0.493)]was significantly lower than that of the non-intervention group.Compared with the non-intervention group,the incidence of PE in the intervention group with different oral doses of aspirin decreased gradually with the increase of drug dose(73.0%vs34.3%Vs 27.8%Vs 26.0%,P<0.05),and presented a significant negative correlation(RS?-1.000,P<0.05).3.The total incidence of intervention group complicated with placental abruption[vs5.9%1.9%,P<0.05,OR:0.481(95%CI:0.205 1.129)],complicated with HELLP syndrome incidence[vs8.8%0.9%,P<0.05,OR:0.189(95%CI:0.050 0.705)]and mother ICU occupancy[vs5.4%0.9%,P<0.05,OR:0.295(95%CI:0.082 1.060)]was significantly lower than not intervention group,The incidence of placental abruption was negatively correlated with aspirin dose(RS=-1.000,P<0.05).There was no significant difference in the incidence of postpartum hemorrhage(14.2%vs6.7%vs19.4%vs 14.0%,P>0.05)between the two groups with or without oral aspirin and its dose.4.Gestational week(37.81±2.30 weeks vS33.96 ±5.29 weeks,P<0.05)and birth weight(2815.30 gVS2065.82 g,P<0.05)were significantly higher in the total intervention group than in the non-intervention group.The incidence of fetal intrauterine[vsl1.3%0.9%,P<0.05,OR:0.149(95%CI:0.039 0.565)],the incidence of preterm(<37 weeks)[vs56.4%20.8%,P<0.05,OR:0.423(95%CI:0.324 0.553)],the incidence of early production<34 weeks[vs43.1%5.7%,P<0.05,OR:0.190(95%CI:0.111 0.324)],SGA rate[vs43.1%20.8%,P<0.05),OR:0.747(95%CI:0.582 0.958)];Apgar score<7@1 min rate[3.8%vs15.7%,P<0.05,OR:0.877(95%CI:0.821 0.935)],Apgar Score<7?5 min rate[0.9%vs7.4%,P<0.05,OR:0.224(95%CI:0.061 0.824)]and umbilical arterial blood gas PH<7.15 rate[1.9%vs8.8%,P<0.05,OR:0.344(95%CI:0.141 0.840)],newborns have gen assisted respiration rate[4.2%vsl1.3%,P<0.05,OR:0.532(95%CI:0.303 0.933)],the incidence of neonatal hypoxic ischemia encephalopathy(0.9%v S3.9%,P<0.05,OR:0.387(95%CI:0.112 1.340)],neonatal mortality[vs25.5%2.8%,P<0.05,OR:0.180(95%CI:0.084 0.386)],the intervention group were significantly lower than not intervention group;Meanwhile,compared with the non-intervention group,the incidence of Apgar Score<7.1 min(15.7%vS4.4%vS4.2%VS2.0%,P<0.05),the rate of umbilical artery blood gas PH<7.15(8.8%vS3.3%VS1.4%VSO%,P<0.05)and neonatal mortality(25.5%vS5.6%VS 1.4%,P<0.05)in the intervention group with different oral doses of aspirin gradually decreased,and were significantly negatively correlated with the aspirin dose(RS=-1.000,P<0.05).5.Every year,oral aspirin during pregnancy in patients with chronic hypertension can save 582 million yuan in hospitalization expenses for newborns.Conclusion:In patients with chronic hypertension,oral aspirin at the end of early pregnancy significantly reduced the incidence of PE,which was significantly negatively correlated with the dose of oral aspirin,delayed the onset of PE in gestational age,and finally effectively improved maternal and child outcomes,and had good health and economic benefits.