Аспирин и преэклампсия

[Dr.Vad]

Аспирин в 2.5-3 раза снижает риск преэклампсии:
N Engl J Med. 2017 Jun 28. doi: 10.1056/NEJMoa1704559.
Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia
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[Dr.Vad]

И степень снижения риска зависит от комплайенса пациентки - если аспирин принимать регулярно, то риск повтора преэклапсии менее 1% или снижение риска в 3.5-4 раза

Preterm preeclampsia occurred in 5/555 (0.9%) participants in the aspirin group with compliance ≥90%, in 8/243 (3.3%) of participants in the aspirin group with compliance <90%, in 22/588 (3.7%) of participants in the placebo group with compliance ≥90%, and in 13/234 (5.6%) of participants in the placebo group with compliance <90%. The odds ratio in the aspirin group for preterm preeclampsia was 0.24 (95% confidence interval, 0.09-0.65) for compliance ≥90% and 0.59 (95% confidence interval, 0.23-1.53) for compliance <90%. Compliance was positively associated with family history of preeclampsia and negatively associated with smoking, maternal age <25 years, Afro-Caribbean and South Asian racial origin, and history of preeclampsia in a previous pregnancy.
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Aspirin for Evidence-Based Preeclampsia Prevention trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia.
Wright D, et al.
Am J Obstet Gynecol. 2017 Sep 6.

[Dr.Vad]

Мета-анализ по аспирину как профилактике преэклампсии - дозы/сроки назначения:

Administration of aspirin was associated with reduction in the risk of preterm preeclampsia (RR: 0.62, 95% CI 0.45 to 0.87), but there was no significant effect on term preeclampsia (RR: 0.92, 95% CI 0.70 to 1.21). The reduction in preterm preeclampsia was confined to the subgroup in which aspirin was initiated at ≤16 weeks' gestation and at a daily dose of ≥100 mg (RR: 0.33, 95% CI 0.19 to 0.57). This effect was also observed in the high-quality studies. The reduction in preterm preeclampsia observed in the largest trial (ASPRE; n=1620; RR: 0.38; 95% CI: 0.20 to 0.72) was similar to that in the five smaller trials in which aspirin was initiated at ≤16 weeks' gestation and at a daily dose of ≥100 mg (n=639; RR: 0.22; 95% CI: 0.07 to 0.66).
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Am J Obstet Gynecol. 2017 Nov 11. pii: S0002-9378(17)32326-8.
Aspirin for the prevention of preterm and term preeclampsia: Systematic review and meta-analysis.