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Obstet Gynecol:昂丹司琼治疗妊娠恶心呕吐与特定出生缺陷风险之间的关系

2018-07-25 xing.T MedSci原创

由此可见,用于治疗妊娠恶心和呕吐的昂丹司琼使用率增加至了13%。 对于所研究的大多数特定出生缺陷,与未治疗相比,妊娠早期使用昂丹司琼治疗恶心和呕吐的风险没有增加,尽管其与腭裂和肾发育不全-发育不良的适度关联值得进一步研究。

近日,妇产科权威杂志Obstetrics and Gynecology上发表了一研究文章,研究人员旨在使用来自两项大型出生缺陷研究的数据来描述昂丹司琼用于治疗妊娠早期恶心和呕吐的时间趋势,并探究了妊娠早期采用昂丹司琼治疗与主要出生缺陷之间的关联。

研究人员使用了两项病例对照研究的数据,即全国出生缺陷预防研究(1997-2011)和斯隆出生缺陷研究(1997-2014)。对照组受试者采用昂丹司琼治疗妊娠早期恶心和呕吐的使用情况以2年为间隔进行计算。研究人员采用未经治疗的妊娠早期恶心和妊娠呕吐的妇女作为参考,计算了妊娠早期昂丹司琼用于治疗妊娠恶心和呕吐与特定出生缺陷之间关联的调整比值比(OR)和95%CI。

在全国出生缺陷预防研究和斯隆出生缺陷研究中,分别纳入了6751和5873名对照母亲和14667例和8533例呕吐母亲,她们报告了妊娠早期恶心和呕吐情况。在对照组的女性中,使用昂丹司琼从2000年前的不到1%增加到2013-2014年期间的13%。使用昂丹司琼与分析的51个缺陷中大多数的风险增加无关。在全国出生缺陷研究中,可观察到肾发育不全-发育不全发生风险增加(调整后的OR,95%CI为1.1-3.0),在全国出生缺陷预防研究中可观察到腭裂风险适度增加(调整OR为1.6,95%CI为1.1-2.3) ,虽然这些发现可能是偶然的结果。

由此可见,用于治疗妊娠恶心和呕吐的昂丹司琼使用率增加至了13%。 对于所研究的大多数特定出生缺陷,与未治疗相比,妊娠早期使用昂丹司琼治疗恶心和呕吐的风险没有增加,尽管其与腭裂和肾发育不全-发育不良的适度关联值得进一步研究。

原始出处:

Parker, Samantha  E.et al.Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects.Obstetrics & Gynecology.2018.https://journals.lww.com/greenjournal/Abstract/publishahead/Ondansetron_for_Treatment_of_Nausea_and_Vomiting.98023.aspx

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