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BMJ:子宫暴露抗抑郁药是否增加后代精神疾病风险?

2017-11-07 吴星 环球医学

在怀孕期间,女性不能及时的调整心态,适应母亲这个角色,那么在怀孕期间很容易出现焦虑、抑郁。因此部分孕妇会选择服用抗抑郁药,抗抑郁药对胎儿有什么样的影响呢?2017年9月,发表在《BMJ》上的一项基于人群的队列研究,考察子宫抗抑郁药暴露和后代精神疾病风险之间的相关性。

在怀孕期间,女性不能及时的调整心态,适应母亲这个角色,那么在怀孕期间很容易出现焦虑、抑郁。因此部分孕妇会选择服用抗抑郁药,抗抑郁药对胎儿有什么样的影响呢?2017年9月,发表在《BMJ》上的一项基于人群的队列研究,考察子宫抗抑郁药暴露和后代精神疾病风险之间的相关性。

目的:旨在调查子宫抗抑郁药暴露和后代精神疾病风险之间的相关性。

设计:基于人群的队列研究。

地点:丹麦国家注册处。

参与者:丹麦905383名在1998~2012年出生的活产单胎,并从出生随访至2014年7月、死亡、移民或首次精神疾病确诊的日期,以先发生为准。其中最长随访周期为16.5年,并有了8.1×106人年的风险。

观察性研究的暴露:根据产妇妊娠前2年内和妊娠期的抗抑郁药使用情况将儿童分为4组:未暴露组、抗抑郁药停用组(妊娠前使用,而妊娠期不使用)、抗抑郁药继续使用组(妊娠前和妊娠期都使用)、新使用组(仅在妊娠期使用)。

主要结局测量:儿童首次确诊为精神疾病,其定义为住院或门诊精神疾病治疗的第一天。精神疾病的风险比使用Cox回归模型进行评估。

结果:总体来说,32400名儿童确诊为精神疾病。精神疾病的调整后15年累积发病率在未暴露组、抗抑郁药停用组、抗抑郁药继续使用组和新使用者组分别为8.0%(95% CI,7.9~8.2)、11.5%(10.3~12.9)、13.6%(11.3~16.3)和14.5%(10.5~19.8)。与抗抑郁药停用组相比,抗抑郁药继续使用组的精神疾病风险增加(HR,1.27;95% CI,1.17~1.38)。

结论:子宫暴露抗抑郁药与精神疾病风险的增加相关。该相关性可归因于产妇潜在疾病的严重程度与子宫抗抑郁药暴露的结合。结果表明,在子宫抗抑郁药暴露研究中,仅关注单一的后代精神疾病过于严苛。

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    2018-03-20 wetgdt
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    2018-08-26 gaoxiaoe
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    2017-11-15 三生有幸9135

    学习一下谢谢分享

    0

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    2017-11-07 三生有幸9135

    学习一下谢谢分享

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