Preventive effect of aspirin combined with metformin on preeclampsia in pregnant women with gestational diabetes and poor blood sugar control

Yan Ming-qin; Yu Xiao-xia; Xu Yu

doi:10.3969/j.issn.1672-8157.2025.02.023

Abstract：Objective To observe the preventive effect of aspirin combined with metformin on preeclampsia in pregnant women with gestational diabetes mellitus(GDM)and poor blood sugar control.Methods A total of 53 patients with GDM treated with metformin hydrochloride extended-release tablets in 3201 Hospital from June 2018 to June 2021 were enrolled in this study as the control group while other 53 treated with a combination of metformin and enteric-coated aspirin tablets from July 2021 to June 2024 were selected as the subjects in the observation group.All patients continued their medication until after delivery.Meanwhile,they received routine health education,diet guidance,exercise guidance,etc.,and injection of insulin aspartate for intervention.The blood glucose level,insulin level,insulin resistance index and coagulation function before and after treatment were compared between the two groups and the occurrence of preeclampsia and adverse reactions were recorded in both groups.Results After treatment,the fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),fasting insulin(FINS),insulin resistance index(HOMA-IR),and fibrinogen(FIB)in the observation group(4.25±0.86)mmol·L-1,(5.58±1.02)mmol·L-1,(13.97±1.21)mU·L-1,(2.64±0.31),(4.08±1.04)g·L-1)were lower than those in the control((5.13±0.94)mmol·L-1,(7.41±1.15)mmol·L-1,(16.42±1.85)mU·L-1,(3.74±0.67),(5.13±1.18)g·L-1)(t=5.028,8.667,8.069,10.848,4.860,all P<0.05).The prothrombin time(PT)and activated partial thromboplastin time(APTT)in the observation group((12.07±1.14)s,(34.62±3.01)s)were higher than those in the control((10.96±1.09)s,(31.17±2.85)s)(t=5.123,6.059,both P<0.05).The preeclampsia incidence was significantly lower in the observation group than in the control(1.89%vs 15.09%)(χ2=4.371,P=0.037).There was no remarkable difference in total inci-dence of adverse reactions between the the observation group and the control(11.32%(6/53)vs 7.55%(4/53))(χ2=0.442,P=0.506).Conclusion Aspirin combined with metformin can effectively control blood sugar in pregnant women with GDM since it can reduce insulin levels and insulin resistance,improve coagulation function and effectively prevent the occurrence of preeclampsia.Furthermore,it is of high safety profile.