在怀孕期间处方阿片类药物暴露和自发早产风险
Olivia M Bosworth1, Maria C Padilla-Azain2, Margaret A Adgent2
1Vanderbilt University, Nashville, Tennessee.
在怀孕期间使用阿片类药物会增加自发早产的风险. 较高的阿片类药物剂量与更高的早产几率有关,强调需要最小的处方阿片类药物使用.
科学领域:
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 在怀孕期间接触阿片类药物与早产有关.
- 之前的研究没有区分自发和指示的早产.
- 阿片类药物使用和早产之间的剂量依赖关系需要进一步调查.
研究的目的:
- 为了确定怀孕期间处方阿片类药物的使用是否与自发早产有关.
- 为了调查这种关联是否依赖于剂量.
主要方法:
- 一项用田纳西州医疗补助计划的回顾性队列进行的病例对照研究.
- 链接的入学,医疗保健接触,医院出院,出生证明和处方数据.
- 匹配了自发早产病例与对照,分析了在分娩前60天内分发的阿片类吗啡毫克相当量 (MME).
主要成果:
- 这项研究包括25391例自发早产和225,696例对照.
- 7.4%的患者在分娩后60天内填写了阿片类药物处方.
- 每次非零类阿片类MME的翻倍都与4%增加自发早产的几率有关 (aOR,1.04;95%CI,1.01-1.08).
结论:
- 总处方阿片类药物剂量与自发早产的几率之间存在正相关性.
- 研究结果支持在怀孕期间尽量减少阿片类药物暴露.
- 建议处方最低有效的阿片类药物剂量.
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