美国预先存在高血压的孕妇中使用抗高血压药物的模式:基于人口的研究
Yanning Wang1,2,3, Nicole E Smolinski1,3, Celeste Ewig1,3
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, United States of America.
PloS one
|July 3, 2024
概括
在怀孕期间使用抗高血压药物有所不同,一些药物被停止使用,而其他药物则在怀孕期间开始使用. 需要进行研究,以优化对孕产妇和胎儿健康的药物选择.
科学领域:
- 心血管医学 心血管医学
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
背景情况:
- 孕期妇女的高血压率不断上升,需要在怀孕期间仔细管理血压.
- 对抗高血压药物的风险-益处概况的有限证据使孕妇的治疗决策变得复杂.
- 这项研究调查了怀孕前,怀孕期间和怀孕后先前存在高血压的女性的抗高血压药物处方模式.
研究的目的:
- 分析不同类型的抗高血压药物在孕妇中使用的模式,这些患者有先前存在的高血压.
- 为了识别不同妊娠阶段和产后使用抗高血压药物的变化.
- 为临床决策提供有关在生育年龄期间安全有效的高血压管理的信息.
主要方法:
- 利用MarketScan®商业数据库 (2011-2020年) 来分析孕妇 (12-55岁) 服用抗高血压药物的情况.
- 根据在最后一次月经周期 (LMP) 之前的住院或门诊接触,定义了先前存在的高血压.
- 在0-3个月的怀孕前期,1-3个月的怀孕前期和0-6个月的产后期评估药物使用情况.
主要成果:
- 确定了超过190万例怀孕,其中20576例患有先前存在的高血压.
- 在怀孕期间,13.9%的基线使用者停止服用药物,而28.9%的非使用者开始治疗.
- 药物治疗模式发生了显著的转变: thiazide 利尿剂,β 阻断剂和 ACE 抑制剂减少,而中央α2-激动剂增加; 尼菲迪平的偏好在第三个三个月超过了阿姆洛迪平.
结论:
- 在怀孕期间,抗高血压药物处方发生了显著的转变,有明显的中止和开始治疗.
- 中央α2-agonists和nifedipine在晚期怀孕阶段使用量增加.
- 进一步的研究至关重要,以评估抗高血压选择和最佳孕产妇和胎儿结果的时间.
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