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The Role of Aspirin for Preeclampsia Prevention in Women with Diabetes
Current Diabetes Reports ( IF 4.2 ) Pub Date : 2020-11-24 , DOI: 10.1007/s11892-020-01365-1
Catherine Finnegan , Fionnuala M. Breathnach

Purpose of Review

A diagnosis of type I or type 2 diabetes confers heightened risk for virtually every obstetric and perinatal complication, with the incidence of superimposed preeclampsia representing a particularly high-risk scenario. Over the past three decades, studies have investigated the role of aspirin in preeclampsia prevention, yielding some promising results for certain at-risk groups, yet unconvincing evidence of benefit among women with pre-pregnancy diabetes. The purpose of this review is to present the current evidence base for aspirin use in pregnancy as a means of mitigating preeclampsia risk in the setting of pregestational type I or type 2 diabetes.

Recent Findings

Meta-analysis data examining low-dose aspirin for preeclampsia prevention in at-risk and low-risk women has demonstrated modest benefit, but subanalyses of cohorts with diabetes have failed to demonstrate a beneficial effect. Evidence is emerging that indicates a benefit only among women who initiate aspirin therapy prior to 16 weeks’ gestation, and uncertainty exists surrounding the effective dose.

Summary

In light of equipoise surrounding the potential role of aspirin for prevention of preeclampsia in women with diabetes, current research is targeted at determining clinical efficacy of aspirin in this high-risk obstetric population.



中文翻译:

阿司匹林在预防糖尿病女性子痫前期中的作用

审查目的

确诊为I型或2型糖尿病会增加几乎所有产科和围产期并发症的风险,子痫前期叠加的发生率特别高。在过去的三十年中,研究人员调查了阿司匹林在预防先兆子痫中的作用,对某些高危人群产生了一些可喜的结果,但尚无令人信服的证据表明怀孕前糖尿病妇女受益。这篇综述的目的是提供当前在妊娠中使用阿司匹林的证据基础,以减轻在妊娠I型或2型糖尿病患者中先兆子痫的风险。

最近的发现

荟萃分析数据显示,低剂量阿司匹林在高危和低风险妇女中预防先兆子痫的作用已显示出一定的获益,但对糖尿病人群的亚组分析未能显示出有益的作用。越来越多的证据表明,仅在妊娠16周之前开始使用阿司匹林治疗的女性中受益,并且有效剂量尚不确定。

概要

鉴于围绕阿司匹林预防糖尿病女性先兆子痫的潜在作用的平衡,目前的研究旨在确定阿司匹林在该高危产科人群中的临床疗效。

更新日期:2020-11-25
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