美国国家公共电台 NPR A Daily Baby Aspirin Could Help Many Pregnancies And Save Lives

 

DAVID GREENE, HOST:

One of the biggest killers¹ of women in childbirth in the United States is something called preeclampsia, a type of high blood pressure in pregnancy². Even when it's not deadly, it can be serious, leading to seizures³ for the mother or to babies being born prematurely⁴. There is a tiny, inexpensive pill that can cut the risk of preeclampsia. But as NPR's Selena Simmons-Duffin reports, not all women who need it are getting it.

SELENA SIMMONS-DUFFIN, BYLINE⁵: When a woman gets preeclampsia during her pregnancy, her blood vessels⁶ constrict⁷. Blood can't flow easily to her kidneys or brain or uterus. That's what's happening inside her body. On the outside...

BRIDGET DESMUKES: My feet were swollen⁸. My hands were swollen.

SIMMONS-DUFFIN: Bridget Desmukes says at the end of her pregnancy eight years ago, something was suddenly very wrong. There was the swelling⁹, and she was incredibly tired. She's a nurse. She knows all about preeclampsia. And she was scared.

DESMUKES: Like, am I going to have a heart attack while I'm going through? You know, am I going to be able to make it through this?

SIMMONS-DUFFIN: She was also aware that, as a black woman, her risk of dying in childbirth is around three times higher than it is for white women.

DESMUKES: You know, we ended up having caesarean section, and they got her out and she was OK. But even through that process, just that fear.

SIMMONS-DUFFIN: That baby who was OK is a big kid now. Her name's Mila. She just turned 8, the middle of five kids.

MILA: (Laughter).

JEFFREY: Aha.

SIMMONS-DUFFIN: The house is lively and musical.

(SOUNDBITE OF PIANO PLAYING)

SIMMONS-DUFFIN: Desmukes and her husband love having a big family, and now she's pregnant again. Having preeclampsia once means she's at high risk for getting it again. So this time, she's taking low-dose aspirin¹⁰ every day.

(SOUNDBITE OF PILL BOTTLE SHAKING)

SIMMONS-DUFFIN: We're not talking about aspirin for pain relief. Pregnant women are supposed to take Tylenol for things like headaches. These are baby aspirin, just 81 milligrams, what people take every day if they've had a heart attack or stroke.

DESMUKES: And I love the fact that they're itty-bitty.

SIMMONS-DUFFIN: So far, everything's going well. No signs of hypertension. Aspirin works by relaxing blood vessels.

JODI ABBOTT: What it does is lower the blood pressure but also improve blood flow to the baby, to the kidneys and to the brain, lowering the chance that the woman would have any complications to her pregnancy that would affect either her or her baby.

SIMMONS-DUFFIN: That's Jodi Abbott, an OB-GYN at Boston Medical Center who specializes in high-risk pregnancies¹¹. She runs the Prenatal Aspirin Project, which does research and advocacy with the goal of getting more women who are at risk of preeclampsia to take low-dose aspirin. Dr. Nyia Noel is her co-director.

NYIA NOEL: This topic is very important to me as a black woman but also as a black obstetrician-gynecologist in the service of women of color every day.

SIMMONS-DUFFIN: Not only are African American women more likely than white women to develop preeclampsia, they're more likely to die from it. Noel tells her patients that low-dose aspirin can reduce the risk of preeclampsia by 24%.

NOEL: It's been shown to be very safe. And things that people worry about, such as bleeding in pregnancy, or something called placental abruption, which is early separation of the placenta, have not shown to be increased in women on low-dose aspirin.

SIMMONS-DUFFIN: It's not just African American women. Lots of women are at risk for preeclampsia. If you're having twins, or if you have a condition like diabetes¹², for instance, you're considered at high risk, and low-dose aspirin is recommended for you. There are also moderate risk factors, like if you're pregnant with your first baby, you're obese¹³ or you're over 35. If you have several of those, aspirin is recommended for you, too. Abbott says, if you add all those things up...

ABBOTT: Eighty-six percent of our patients would be eligible¹⁴ for aspirin based on those criteria¹⁵. When you look at a number like 86%, you can understand why I would be in favor, as a public health initiative, of all pregnant women getting it.

SIMMONS-DUFFIN: As she sees it, screening for risk factors inevitably¹⁶ means someone who could benefit will get missed. She argues since there aren't significant downsides, all pregnant women should take it.

ABBOTT: And if I would guess ahead to 10 years, my guess is that you'll be able to buy, included in your prenatal vitamin, low-dose aspirin.

SIMMONS-DUFFIN: So coming to a prenatal near you?

ABBOTT: (Laughter) Yes.

SIMMONS-DUFFIN: Not everyone is convinced that a universal approach is a good idea here. Count Dr. Karina Davidson of Northwell Health among them.

KARINA DAVIDSON: I am a member, as a volunteer, of the United States Preventive Services Task Force.

SIMMONS-DUFFIN: This is an influential¹⁷ group. Their current prenatal aspirin recommendations, put out in 2014, do not recommend that women without any risk factors for preeclampsia take low-dose aspirin.

DAVIDSON: When we looked in 2014, we found little evidence that existed that, in average-risk populations, there was benefit.

SIMMONS-DUFFIN: So for average-risk women, the bar is, there has to actually be a benefit?

DAVIDSON: Yes.

SIMMONS-DUFFIN: You can't just recommend, take aspirin because - why not?

DAVIDSON: Right.

SIMMONS-DUFFIN: They just began looking to see if new research has come along since 2014 to change their guidance. That review won't be finished for several years. Dr. Jodi Abbott says, in the meantime, the Prenatal Aspirin Project is trying to figure out why more at-risk women aren't taking low-dose aspirin.

ABBOTT: We would have our patients say to us, I got a prescription¹⁸, but I'm going to Google it before I take it. A lot of references that patients use - including apps, websites, books - say don't take aspirin while you're pregnant.

SIMMONS-DUFFIN: Probably referring to high-dose aspirin for pain relief. Abbott also thinks a lot of doctors, nurses and pharmacists might not be up to date on the low-dose aspirin recommendations.

ABBOTT: A number of commercial pharmacies¹⁹ would put warnings on aspirin, saying, don't take if you're pregnant.

SIMMONS-DUFFIN: The Prenatal Aspirin Project got CVS, Walgreens and Walmart to stop doing that, trying to eliminate that barrier.

ABBOTT: Everybody deserves a healthy baby and a healthy mother, and we're failing at that right now.

SIMMONS-DUFFIN: Of course, Dr. Nyia Noel says, low-dose aspirin isn't the only answer to the country's high rate of maternal²⁰ mortality.

NOEL: There are certainly other things to be addressed - structural²¹ barriers, structural racism²² involved, and the disparities that exist.

SIMMONS-DUFFIN: This tiny pill isn't going to fix all of that.

NOEL: It's not. But it is something.

SIMMONS-DUFFIN: And, she says, it has great potential to reduce the number of cases of preeclampsia, which kills many women every year.

Selena Simmons-Duffin, NPR News.

1 killers   

凶手( killer的名词复数 )； 消灭…者； 致命物； 极难的事

参考例句：

• He remained steadfast in his determination to bring the killers to justice. 他要将杀人凶手绳之以法的决心一直没有动摇。
• They were professional killers who did in John. 杀死约翰的这些人是职业杀手。

2 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

3 seizures   

n.起获( seizure的名词复数 )；没收；充公；起获的赃物

参考例句：

• Seizures of illicit drugs have increased by 30% this year. 今年违禁药品的扣押增长了30%。 来自《简明英汉词典》
• Other causes of unconsciousness predisposing to aspiration lung abscess are convulsive seizures. 造成吸入性肺脓肿昏迷的其他原因，有惊厥发作。 来自辞典例句

4 prematurely   

adv.过早地，贸然地

参考例句：

• She was born prematurely with poorly developed lungs. 她早产，肺部未发育健全。 来自《简明英汉词典》
• His hair was prematurely white, but his busy eyebrows were still jet-black. 他的头发已经白了，不过两道浓眉还是乌黑乌黑的。 来自辞典例句

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 vessels   

n.血管( vessel的名词复数 )；船；容器；（具有特殊品质或接受特殊品质的）人

参考例句：

• The river is navigable by vessels of up to 90 tons. 90 吨以下的船只可以从这条河通过。 来自《简明英汉词典》
• All modern vessels of any size are fitted with radar installations. 所有现代化船只都有雷达装置。 来自《现代汉英综合大词典》

7 constrict   

v.压缩，收缩，阻塞

参考例句：

• Men and women alike have been constricted by traditional sexual roles.男性和女性同样受到传统性别角色的束缚。
• Severe migraine can be treated with a drug which constricts the blood vessels.严重的偏头疼可以用一种收缩血管的药物进行治疗。

8 swollen   

adj.肿大的，水涨的；v.使变大，肿胀

参考例句：

• Her legs had got swollen from standing up all day.因为整天站着，她的双腿已经肿了。
• A mosquito had bitten her and her arm had swollen up.蚊子叮了她，她的手臂肿起来了。

9 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

10 aspirin   

n.阿司匹林

参考例句：

• The aspirin seems to quiet the headache.阿司匹林似乎使头痛减轻了。
• She went into a chemist's and bought some aspirin.她进了一家药店，买了些阿司匹林。

11 pregnancies   

怀孕，妊娠( pregnancy的名词复数 )

参考例句：

• Since the wartime population needed replenishment, pregnancies were a good sign. 最后一桩倒不失为好现象，战时人口正该补充。
• She's had three pregnancies in four years. 她在四年中怀孕叁次。

12 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

13 obese   

adj.过度肥胖的，肥大的

参考例句：

• The old man is really obese,it can't be healthy.那位老人确实过于肥胖了，不能算是健康。
• Being obese and lazy is dangerous to health.又胖又懒危害健康。

14 eligible   

adj.有条件被选中的；(尤指婚姻等)合适(意)的

参考例句：

• He is an eligible young man.他是一个合格的年轻人。
• Helen married an eligible bachelor.海伦嫁给了一个中意的单身汉。

15 criteria   

n.标准

参考例句：

• The main criterion is value for money.主要的标准是钱要用得划算。
• There are strict criteria for inclusion in the competition.参赛的标准很严格。

16 inevitably   

adv.不可避免地；必然发生地

参考例句：

• In the way you go on,you are inevitably coming apart.照你们这样下去，毫无疑问是会散伙的。
• Technological changes will inevitably lead to unemployment.技术变革必然会导致失业。

17 influential   

adj.有影响的，有权势的

参考例句：

• He always tries to get in with the most influential people.他总是试图巴结最有影响的人物。
• He is a very influential man in the government.他在政府中是个很有影响的人物。

18 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

19 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网

20 maternal   

adj.母亲的，母亲般的，母系的，母方的

参考例句：

• He is my maternal uncle.他是我舅舅。
• The sight of the hopeless little boy aroused her maternal instincts.那个绝望的小男孩的模样唤起了她的母性。

21 structural   

adj.构造的，组织的，建筑（用）的

参考例句：

• The storm caused no structural damage.风暴没有造成建筑结构方面的破坏。
• The North American continent is made up of three great structural entities.北美大陆是由三个构造单元组成的。

22 racism   

n.民族主义；种族歧视(意识)

参考例句：

• He said that racism is endemic in this country.他说种族主义在该国很普遍。
• Racism causes political instability and violence.种族主义道致政治动荡和暴力事件。