与分娩时使用SSRI有关的出血和出血并发症风险的剂量依赖性增加
Malin Öndemark1, Lennart Nordström2, Pelle G Lindqvist3
1Department of Obstetrics and Gynaecology, Sodersjukhuset, Sweden.
概括
选择性血红素再吸收抑制剂 (SSRI) 在怀孕期间以剂量依赖的方式增加分娩时的出血风险. 较高的SSRI剂量与更大的产后出血和贫血有关,为孕妇的临床管理提供了信息.
科学领域:
- 产科和妇科 产科和妇科
- 围产期心理健康问题
- 药理学 药理学是指药理学的学科.
背景情况:
- 孕期抑郁症对母亲和新生儿都有风险,包括自杀和不良后果.
- 选择性血清素再吸收抑制剂 (SSRI) 用于抑郁症,但可能会增加分娩出血并发症.
- 怀孕期间SSRI相关出血风险的剂量依赖性尚未得到充分确立.
研究的目的:
- 调查选择性血红素再吸收抑制剂 (SSRI) 剂量与分娩期间出血并发症发生率之间的关系.
- 为了确定SSRI使用与产后出血或贫血之间是否存在剂量依赖的关联.
主要方法:
- 一项基于医院的队列研究于2007年至2011年在卡罗林斯卡大学医院进行.
- 334名在分娩时使用SSRI的妇女与31,929名对照进行了比较,SSRI使用者按中度或高剂量分类.
- 分析了母亲的电子健康记录,以评估出血并发症,产后出血和贫血.
主要成果:
- 随着较高的SSRI剂量,观察到产后出血 (≥1000毫升) 的显著剂量依赖增加.
- 产后贫血率也随着SSRI使用而以剂量依赖的方式增加.
- 与对照组相比,使用中度或高剂量的SSRI的女性的平均血液损失显著更高.
结论:
- 在SSRI使用和分娩期间出血并发症之间存在明显的剂量依赖关系.
- 这一剂量依赖性发现在临床上与治疗孕妇服用SSRI相关.
- 临床医生可以使用SSRI剂量信息来更好地评估和管理这种患者群体的出血风险.
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