Aspirin Prophylaxis for Preeclampsia

摘要

The U.S. Preventive Services Task Force recommends daily low-dose aspirin (81 mg/day) after weeks of pregnancy in women who are at high risk for preeclampsia to reduce the occur-rencent of preeclampsia, preterm birth and intrauterine growth restriction. The recommendation, published online September 9 in Annals of Internal Medicine, applies to pregnant women at high risk for preeclampsia, who are asymptomatic and have no contraindication to or history of adverse effects from aspirin therapy. Risk factors for preeclampsia include history of preeclampsia (including early-onset), multifetal gestation and some preexisting chronic and autoimmune diseases. The full recommendations are available at http://annals.org/article.aspx?artideid= 1902276. Weight Control During Pregnancy According to a study published in the September issue of the journal Obesity, attending weekly group support meetings, getting nutrition and diet advice and keeping food and exercise journals can help women with obesity successfully manage weight gain during pregnancy. Researchers in Oregon randomly assigned 114 pregnant women with obesity (body mass index >30) between 7 and 21 weeks' gestation to one of two programs: an intensive weight management program that included weekly group meetings, weigh-ins, personalized caloric goals, and food and exercise diaries, or the usual care, which consisted of diet and exercise advice provided at one meeting with a dietitian. By 34 weeks of pregnancy, women in the intensive intervention group had gained an average of 11 pounds compared with a gain of 18 pounds for women who got the usual care. Two weeks after birth, women in the intervention group weighed approximately 6 pounds less than when they started the study compared with an average weight gain of 3 pounds among women in the usual care group. In addition, women in the intensive intervention group were significantly less likely to have a large-for-gestational age newborn (9 percent vs 26 percent).