PDF(Pubmed)
Abstract：
UNASSIGNED: Positive antiphospholipid antibodies (aPLs) and chronic hypertension (CH) in pregnancy are important causes of maternal and neonatal morbidity and mortality. However, there are no relevant studies on the treatment of aPL-positive pregnant women with CH. This study aimed to determine the effect of low-dose aspirin (LDA) plus low-molecular-weight heparin (LMWH) on maternal and perinatal outcomes in persistently aPL-positive pregnant women with CH.
UNASSIGNED: This study was performed at the First Affiliated Hospital of Dalian Medical University in Liaoning, China, from January 2018 to December 2021. Pregnant women diagnosed CH and persistently positive aPL who had no autoimmune disease such as systemic lupus erythematosus, antiphospholipid syndrome were recruited and divided into control group (LDA and LWMH were not used), LDA group (LDA was used) and LDA plus LMWH group (both LDA and LMWH were used) according to whether they use LDA and/or LMWH. A total of 81 patients were enrolled, including 40 patients in the control group, 19 patients in the LDA group, and 22 patients in the LDA plus LMWH group. The maternal and perinatal outcomes of LDA plus LMWH therapy were analysed.
UNASSIGNED: Compared with control group, the rate of severe preeclampsia in LDA group (65.00% vs. 31.58%, p = 0.016) and LDA plus LMWH group (65.00% vs. 36.36%, p = 0.030) had a statistically significant reduction. Compared with control group, the rate of fetal loss in LDA group (35.00% vs. 10.53%, p = 0.014) and LDA plus LMWH group (35.00% vs. 0.00%, p = 0.002) had a statistically significant reduction. Compared with control group, the rate of live birth in LDA group (65.00% vs. 89.74%, p = 0.048) and LDA plus LMWH group (65.00% vs. 100.00%, p = 0.002) had a statistically significant increased. Compared withcontrol group, the incidence of early-onset preeclampsia (47.50% vs. 36.84%, p = 0.008) and early-onset severe preeclampsia (47.50% vs. 13.64%, p = 0.001) in the LDA plus LMWH group decreased and were statistically different. Furthermore, we also found that LDA or LDA plus LMWH hadn\'t increase the rate of blood loss and placental abruption.
UNASSIGNED: Both LDA and LDA combined with LMWH could decrease the incidence of severe preeclampsia, decrease the rate of foetal loss, increase the rate of live birth. However, LDA plus LWMH could reduce and delay the onset of severe preeclampsia, prolong the gestational age and increase the rate of full-term delivery, improve the maternal and perinatal outcomes.
UNASSIGNED: This study was performed at the First Affiliated Hospital of Dalian Medical University in Liaoning, China, from January 2018 to December 2021. Pregnant women diagnosed CH and persistently positive aPL who had no autoimmune disease such as systemic lupus erythematosus, antiphospholipid syndrome were recruited and divided into control group (LDA and LWMH were not used), LDA group (LDA was used) and LDA plus LMWH group (both LDA and LMWH were used) according to whether they use LDA and/or LMWH. A total of 81 patients were enrolled, including 40 patients in the control group, 19 patients in the LDA group, and 22 patients in the LDA plus LMWH group. The maternal and perinatal outcomes of LDA plus LMWH therapy were analysed.
UNASSIGNED: Compared with control group, the rate of severe preeclampsia in LDA group (65.00% vs. 31.58%, p = 0.016) and LDA plus LMWH group (65.00% vs. 36.36%, p = 0.030) had a statistically significant reduction. Compared with control group, the rate of fetal loss in LDA group (35.00% vs. 10.53%, p = 0.014) and LDA plus LMWH group (35.00% vs. 0.00%, p = 0.002) had a statistically significant reduction. Compared with control group, the rate of live birth in LDA group (65.00% vs. 89.74%, p = 0.048) and LDA plus LMWH group (65.00% vs. 100.00%, p = 0.002) had a statistically significant increased. Compared withcontrol group, the incidence of early-onset preeclampsia (47.50% vs. 36.84%, p = 0.008) and early-onset severe preeclampsia (47.50% vs. 13.64%, p = 0.001) in the LDA plus LMWH group decreased and were statistically different. Furthermore, we also found that LDA or LDA plus LMWH hadn\'t increase the rate of blood loss and placental abruption.
UNASSIGNED: Both LDA and LDA combined with LMWH could decrease the incidence of severe preeclampsia, decrease the rate of foetal loss, increase the rate of live birth. However, LDA plus LWMH could reduce and delay the onset of severe preeclampsia, prolong the gestational age and increase the rate of full-term delivery, improve the maternal and perinatal outcomes.
摘要：
■妊娠期抗磷脂抗体（aPLs）阳性和慢性高血压（CH）是孕产妇和新生儿发病和死亡的重要原因。然而,目前尚无关于aPL阳性孕妇CH治疗的相关研究。这项研究旨在确定低剂量阿司匹林（LDA）加低分子量肝素（LMWH）对持续aPL阳性的CH孕妇的孕产妇和围产期结局的影响。
■本研究在辽宁大连医科大学附属第一医院进行,中国,从2018年1月到2021年12月。孕妇诊断为CH和持续阳性的aPL，没有自身免疫性疾病，如系统性红斑狼疮，招募抗磷脂综合征并分为对照组（不使用LDA和LWMH），根据它们是否使用LDA和/或LMWH,LDA组(使用LDA)和LDA加LMWH组(使用LDA和LMWH两者)。共纳入81例患者，包括对照组的40名患者，LDA组19例，LDA加LMWH组22例。分析LDA联合LMWH治疗的母婴结局。
■与对照组相比，LDA组重度子痫前期发生率(65.00%vs.31.58%，p=0.016）和LDA加LMWH组（65.00％vs.36.36%，p=0.030）具有统计学上的显着降低。与对照组相比,LDA组胎儿丢失率(35.00%vs.10.53%,p=0.014）和LDA加LMWH组（35.00%vs.0.00%,p=0.002）具有统计学上的显着降低。与对照组相比,LDA组的活产率(65.00%vs.89.74%,p=0.048）和LDA加LMWH组（65.00％vs.100.00%,p=0.002）具有统计学上的显着增加。与对照组相比,早发型先兆子痫的发病率(47.50%vs.36.84%,p=0.008）和早发型重度子痫前期（47.50%vs.13.64%，p=0.001)在LDA加LMWH组中下降且有统计学差别。此外，我们还发现LDA或LDA加LMWH并没有增加失血率和胎盘早剥。
■LDA和LDA联合LMWH均可降低重度子痫前期的发生率，降低胎儿损失率，提高活产率。然而,LDA加LWMH可以减少和延缓重度子痫前期的发生，延长胎龄，提高足月分娩率，改善孕产妇和围产期结局。
■本研究在辽宁大连医科大学附属第一医院进行,中国,从2018年1月到2021年12月。孕妇诊断为CH和持续阳性的aPL，没有自身免疫性疾病，如系统性红斑狼疮，招募抗磷脂综合征并分为对照组（不使用LDA和LWMH），根据它们是否使用LDA和/或LMWH,LDA组(使用LDA)和LDA加LMWH组(使用LDA和LMWH两者)。共纳入81例患者，包括对照组的40名患者，LDA组19例，LDA加LMWH组22例。分析LDA联合LMWH治疗的母婴结局。
■与对照组相比，LDA组重度子痫前期发生率(65.00%vs.31.58%，p=0.016）和LDA加LMWH组（65.00％vs.36.36%，p=0.030）具有统计学上的显着降低。与对照组相比,LDA组胎儿丢失率(35.00%vs.10.53%,p=0.014）和LDA加LMWH组（35.00%vs.0.00%,p=0.002）具有统计学上的显着降低。与对照组相比,LDA组的活产率(65.00%vs.89.74%,p=0.048）和LDA加LMWH组（65.00％vs.100.00%,p=0.002）具有统计学上的显着增加。与对照组相比,早发型先兆子痫的发病率(47.50%vs.36.84%,p=0.008）和早发型重度子痫前期（47.50%vs.13.64%，p=0.001)在LDA加LMWH组中下降且有统计学差别。此外，我们还发现LDA或LDA加LMWH并没有增加失血率和胎盘早剥。
■LDA和LDA联合LMWH均可降低重度子痫前期的发生率，降低胎儿损失率，提高活产率。然而,LDA加LWMH可以减少和延缓重度子痫前期的发生，延长胎龄，提高足月分娩率，改善孕产妇和围产期结局。
