Low-dose prophylactic aspirin is widely recommended for pregnant women for the prevention of preeclampsia (PE). Although the efficacy of aspirin in preventing PE has been evaluated in many studies, due to the differences in dosage, initiation time, and screening methods for the identification of women at high risk of PE and the lack of a uniform opinion on the medication regimen of aspirin, currently in China there is no consensus on the standardized treatment scheme of aspirin for the prevention of PE in clinical guidelines. Herein, we reviewed the current available evidence and the recommendations of clinical guidelines concerning the controversies about aspirin dosage as well as the timing of starting and stopping aspirin, so as to provide further guidance for clinical practice. Based on the existing research findings on and clinical practice of using aspirin for PE prevention, we suggested that PE risk screening should be conducted at 11-13+6 weeks of gestation. In addition, the recommended dose for prophylactic use of aspirin for pregnant women at high risk of PE is 150 mg/d, and the recommended minimum effective dose is 100 mg/d. Pregnant women at high risk of PE should start taking low-dose aspirin orally before 16 weeks of pregnancy. Week 36 of gestation is considered the window of opportunity for discontinuation of low-dose aspirin.
孕期服用低剂量阿司匹林是目前国内外专家广泛推荐的子痫前期（preeclampsia, PE）预防方法。尽管该方法在PE预防中已有较多报道，但是阿司匹林标准化预防PE的治疗方案仍未在国内的临床指南中达成共识。这是由于在现有研究中，高危人群服用阿司匹林的剂量、初始时间和筛查方法不同，尚未对阿司匹林用药方案形成统一结论。本文基于循证医学证据，总结现有指南推荐意见，对阿司匹林在预防PE时的剂量、具体用药时机、起止时间等焦点问题进行综述，为临床实践提供依据。综合目前阿司匹林预防PE的研究结果及临床实践，我们建议：PE风险筛查应在妊娠11～13+6周时进行；PE高风险孕妇预防性使用阿司匹林的推荐剂量为150 mg/d，最低有效推荐剂量为100 mg/d；PE高风险孕妇于妊娠16周前开始口服低剂量阿司匹林；妊娠36周为低剂量阿司匹林的停药时机。
Keywords: Aspirin; Low-dose prophylaxis; Preeclampsia.
Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).