小剂量阿司匹林预防慢性HBV感染孕妇子痫前期和改善妊娠结局的作用研究OACSTPCD

Background Preeclampsia seriously endangers the safety of mother and child.Currently,domestic and foreign guidelines recommend that pregnant women with high-risk factors use aspirin to prevent the occurrence of preeclampsia.However,there are few clinical studies on pregnant women with chronic HBV infection,which is a high-risk factor for preeclampsia.Objective To explore the clinical outcomes of low-dose aspirin in preventing preeclampsia in pregnant women with chronic HBV infection.Methods Pregnant women with chronic HBV infection and high risk factors for preeclampsia who underwent regular prenatal examinations and successfully delivered at the Obstetrics and Gynecology Department of the Fifth Medical Center of Chinese PLA General Hospital from January 2019 to December 2022 were selected as the study objects.According to whether aspirin was used during pregnancy,pregnant women were divided into medication group(taking 100mg/d of aspirin before bedtime every night at 12-16 weeks of pregnancy and stopping at 36 weeks of pregnancy)and untreated group.The blood pressure,liver function,coagulation function,and pregnancy outcomes of the two groups of pregnant women were compared at 12,20 and 32 weeks of pregnancy,and before delivery.Results A total of 134 pregnant women with chronic HBV infection were collected,with 50 cases in the medication group having an average age of(34.38±3.95)years,and 84 cases in the untreated group,with an average age of(34.59±4.58)years.There was no statistically significant difference in age between the two groups(P＞0.05).The systolic and diastolic blood pressure at 32 weeks of pregnancy and before delivery in the medication group were lower than those in the untreated group(P＜0.05),and the incidence of preeclampsia was lower than that of the untreated group(2.00％[1/50]vs 14.29％[12/84],P=0.043).There was no statistically significant difference in liver function indicators between the two groups(P＞0.05).Among coagulation indicators,only prothrombin time was significantly higher in the medication group during delivery than that in the untreated group([11.18±0.76]vs[10.71±0.65],P=0.018).The gestational week of delivery in the medication group was longer than that in the untreated group([38.76±1.22]vs[35.64±1.63],P＜0.001).The neonatal asphyxia rate(0％vs 8.3％,P=0.036)and premature birth rate(4.00％vs 15.48％,P=0.042)were lower in the medication group than those in the untreated group,and the differences were statistically significant.Conclusion In pregnant women with chronic HBV infection at high risk of preeclampsia,prophylactic use of low-dose aspirin can significantly reduce the occurrence of preeclampsia,improve coagulation indicators,and reduce the occurrence of adverse pregnancy outcomes.