第一个三个月使用抗发作药物和流产风险:基于人口的队列研究
Harriet Forbes1,2, Paul Madley-Dowd2,3, Viktor Ahlqvist3,4
1Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK Harriet.Forbes@lshtm.ac.uk.
在怀孕早期使用抗发作药物 (ASM) 似乎不会增加流产风险. 显而易见的联系可能是由于潜在的健康状况,而不是药物本身.
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.
- 流行病学 流行病学
背景情况:
- 第一季度使用抗发作药物 (ASM) 与更高的流产风险有关.
- 了解这种关联对于在怀孕期间管理和精神疾病至关重要.
研究的目的:
- 调查第一季度抗发作药物使用与流产风险之间的关联.
- 为了确定底层条件是否对观察到的关联产生了误解.
主要方法:
- 基于人口的队列研究,使用英国医疗保健数据 (1995-2018).
- 预计流产的危险比率 (HR) 与使用考克斯回归的第一季度ASM暴露.
- 根据潜在的混因素进行调整,包括ASM指示.
主要成果:
- 14.5%的孕妇在第一季度接触ASM导致流产,而12.2%的孕妇没有.
- 调整后的分析显示,流产的相对风险是1.06倍 (HR1.06,95% CI 1.00-1.13).
- 在患有的女性中没有明显的关联,但在患有精神疾病的女性中观察到;然而,怀疑因指示而混.
结论:
- 没有明确的证据表明,在第一季度使用ASM会直接增加流产风险.
- 显而易见的关联可能会被潜在的疾病 (如双相情感障碍) 或未测量的变量所混.
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