与第一季度抗精神病药物暴露相关的先天性形风险:一种倾向性评分加权的基于人口的队列研究
Joe K N Chan1, Krystal C K Lee1, Corine S M Wong2
1Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
概括
产前接触第二代抗精神病药物 (SGA) 可能会略微增加重大先天性形 (CMs) 的风险. 然而,在敏感性分析中发现的结果不一致,这表明需要进一步研究怀孕期间抗精神病药物的安全性.
科学领域:
- 生殖毒理学 生殖毒理学
- 围产阶段的精神病学
- 药学流行病学 药学流行病学
背景情况:
- 人们越来越担心抗精神病药物的致病性潜力.
- 以前对抗精神病药物和先天性形 (CMs) 的研究产生了相互矛盾的结果,主要集中在西方人群中.
研究的目的:
- 调查在香港产前接触抗精神病药物后出现主要和器官/系统特异性CM的风险.
- 分析第一季度暴露于第二代抗精神病药物 (SGA) 与第一代抗精神病药物 (FGA) 和CMs之间的关联.
主要方法:
- 一项以人口为基础的研究利用了2003年至2018年期间分娩第一个/独生子女的妇女 (15-50岁) 的医疗保健数据.
- 倾向性得分 (PS) 权衡的逻辑回归分析检查了与第一季度暴露于SGA,FGA和特定抗精神病药物相关的CM风险.
主要成果:
- SGA暴露与CMs风险增加有关 (调整后几率比: 2.11 [95% CI: 1.19-3.86]),尽管这并非所有灵敏度分析都一致支持.
- 对高剂量 olanzapine 和 quetiapine 观察到较高的风险,但具有较大的置信区间.
- 在SGA,FGA或单个抗精神病药物和器官/系统特定形之间没有发现显著的关联.
结论:
- 观察到与SGA相关的重大形风险可能会略有增加,但在敏感性分析中缺乏一致的肯定,从而无法得出最终结论.
- 需要进一步进行大规模的研究,以澄清个别抗精神病药物对怀孕期间特定发育不良的比较安全性.
相关概念视频
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
580
Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
580
Teratogenicity
2.4K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.4K
Biological Causes of Schizophrenia
55
Schizophrenia, a severe psychiatric disorder, arises from a complex interplay of biological factors, including genetic predisposition, structural brain abnormalities, neurotransmitter dysregulation, and developmental irregularities. These factors collectively contribute to the onset and progression of the disorder, which typically manifests in late adolescence or early adulthood.
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
55
Antidepressant Drugs: MAOIs and Other Agents
225
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
225
Psychosis and Antipsychotic Drugs: Overview
236
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
236
Psychological and Sociocultural Causes of Schizophrenia
83
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
83


