ผลของการใช้ยาแอสไพรินสำหรับการป้องกันภาวะครรภ์เป็นพิษในสตรีตั้งครรภ์ความเสี่ยงปานกลาง-สูง ในโรงพยาบาลพระนครศรีอยุธยา

Abstract

Objective: To study the effect of aspirin for pre-eclampsia prevention in medium-high-risk pregnant women at Phra Nakhon Si Ayutthaya Hospital.

Methods: This was a retrospective cohort study. Data were collected from the medical records of pregnant women at high risk for pre-eclampsia attending Phra Nakhon Si Ayutthaya Hospital between 2017 and 2022. The sample size was estimated using the formula for two population proportions, the aspirin and non-aspirin groups having 141 cases each. Data were analyzed using descriptive statistics: mean, standard deviation, number, and percentage. Inferential statistics were performed for correlation alongwith chi-square or Fisher exact and independent t-test. Moreover, the risk factors were analyzed using regression models with RR and 95% CI intervals.

Results: Of 290 cases divided equally into the group receiving or not receiving aspirin for the prevention of pre-eclampsia, the group on aspirin had 9 cases of pre-eclampsia (6.20%) compared to 12 cases (20.68%) in the group not received aspirin. The pregnant women group not receiving aspirin had a significantly higher number of cases of hypertension in pregnancy (35.17% vs 20%, p=0.004) and hypertension before pregnancy (40% vs 13.1%, p<0.001) than those receiving aspirin. Likewise, the women who received aspirin had a significantly higher number of cesarean sections than those without it (77.93% vs 67.59%, p= 0.048). The incidence of pregnancy < 37 weeks, low body weight < 2,500 grams, Apgar score 1 min ≤ 7, Vaginal delivery, transfer to NICU, and postpartum hemorrhage in the women with or without aspirin were 19.31% vs 21.38%, 17.24% vs 15.17%, 8.28% vs 11.03%, 31.72% vs 20.69%, 0% vs 1.38%, and 1.38% vs 2.07% without statistical significance between the groups. A multivariant regression analysis found that no aspirin significantly increases the incidence of gestational hypertension (Adj. RR 2.02, 95%CI; 1.17-3.45, p=0.01).

Conclusion: High blood pressure is a risk factor for pre-eclampsia, and aspirin can reduce the incidence of pre-eclampsia in pregnant women.