Influencing factors analysis of low-dose aspirin on pre-eclampsia in gravidae with abnormal uterine artery blood flow spectrum

Abstract

Objective To analyze influencing factors of low-dose aspirin on pre-eclampsia (PE) in gravidae with abnormal uterine artery blood flow spectrum. Methods From February 2013 to December 2014, a total of 90 gravidae with abnormal uterine artery blood flow spectrum were enrolled into this study. They were divided into 2 groups, study group (n=45) and control group (n=45) according to whether taking low-dose aspirin or not. Clinic data between two groups were retrospectively analyzed and multivariate unconditional logistic regression analysis was conducted to explore the influencing factors of low-dose aspirin on PE in gravidae with abnormal uterine artery blood flow spectrum. ① The clinical data, including constituent ratio of age, age, body mass index (BMI), gestational age at delivery, proportion of hypertension and diabetes mellitus history, constituent ratio of modes of delivery, diastolic pressure, systolic pressure blood pressure and 24 h urinary protein quantitation during first trimester of gravidae between two groups, ass well as constituent ratio of neonatal gender and birth weight of infants between two groups, were compared. ② The diastolic pressure, systolic pressure and 24 h urinary protein quantitation during second and third trimester between two groups were detected and compared. ③ Univariate analysis was conducted on the clinical data between gravidae with PE and gravidae without PE. Based on the results of existing studies, clinical experience and univariate analysis results, multivariate unconditional logistic regression analysis were conducted about low-dose aspirin on PE in gravidae with abnormal uterine artery blood flow spectrum. The procedures followed in this study were in line with the ethical standards set by Ethical Review Board of Investigation in Human Beings of Yan′an University Affiliated Hospital and were approved by the committee. The study obtained the informed consent of each subject, and signed a clinical research informed consent with each subject. Results ① There were no significant differences between two groups in the aspects of constituent ratio of age, age, BMI, gestational age at delivery, proportion of hypertension and diabetes mellitus history, constituent ratio of modes of delivery, diastolic pressure, systolic pressure and 24 h urinary protein quantitation during first trimester, as well as constituent ratio of neonatal gender and birth weight of infants (P>0.05). ② The diastolic pressure, systolic pressure and 24 h urinary protein quantitation during second and third trimester in study group were all lower than those of control group (second trimester: t=2.144, P=0.012; t=5.632, P=0.009; t=10.310, P<0.001; third trimester: t=14.680, P<0.001; t=20.431, P<0.001; t=106.21, P<0.001). ③ The incidence of PE in study group was 6.7% (3/45), which was lower than that of 44.4% (20/45) in control group (χ2=5.780, P=0.003). ④ The univariate analysis showed the following results, there were significant differences between gravidae with PE and gravidae without PE in the aspects of constituent ratio of age, proportion of hypertension history and constituent ratio of neonatal gender (χ2=6.317, P=0.012; χ2=7.220, P=0.007; χ2=5.332, P=0.021). Furthermore, multivariate unconditional logistic regression analysis showed that, low-dose aspirin (OR=0.015, 95%CI: 0.002-0.248, P=0.005) and female gender (OR=0.131, 95%CI: 0.014-0.649, P=0.016) were the independent protective factors, and age under 20-year-old (OR=6.767, 95%CI: 3.418-7.084, P=0.024) and age over 40-year-old (OR=3.360, 95%CI: 1.849-5.051, P=0.044) were the independent risk factors of PE in gravidae with abnormal uterine artery blood flow spectrum. Conclusions Low-dose aspirin can be used as one of the options for gravidae with abnormal uterine artery blood flow to prevent PE in clinic, especially for the age under 20-year-old and over 40-year-old. Key words: Aspirin; Pre-eclampsia; Ultrasonography, prenatal; Uterine artery; Pregnant women