USPSTF建议低剂量阿司匹林预防先兆子痫

美国预防服务工作组(USPSTF)建议对子痫前期高危人群在妊娠12周后使用低剂量阿司匹林作为预防药物。这一建议形成了2月23日在线发布的建议声明草案的基础。

Jillian T. Henderson, Ph.D., M.P.H., from the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues reviewed updated evidence on the effectiveness and potential harms of daily aspirin use in pregnancy to prevent preeclampsia-associated morbidity and mortality. Thirty-three studies met the inclusion criteria. Eighteen trials assessed aspirin effectiveness in individuals at increased risk for preeclampsia. Aspirin dosage ranged from 50 to 150 mg/day. The researchers found that these interventions were associated with reduced risks for perinatal mortality,早产，且小于妊娠期/宫内生长限制（分别合并相对风险，0.79,0.80和0.82）。在Preclampsia的风险中也有显着的减少（合并相对风险，0.85）。未观察到在怀孕的第二或第三个三个月期间服用的每日阿司匹林使用的清晰证据。

基于这些发现，USPSTF有一定把握地得出结论:每天服用维生素d有实质性的净效益低剂量阿司匹林用于子痫前期高危孕妇。对于子痫前期高危人群，建议在妊娠12周后服用低剂量阿司匹林(81毫克/天)(B建议)。

建议声明和证据审查草案已经发布，征求公众意见;评论可以在2021年2月23日至3月22日提交。

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