在药物使用增加的背景下加快不良怀孕结果研究:用于信号优先级的并行回顾性队列分析
Yeon Mi Hwang1,2,3, Samantha N Piekos1, Alison G Paquette1,4,5
1Institute for Systems Biology, Seattle, WA, USA.
BMC medicine
|October 25, 2024
概括
怀孕期间的药物使用显著增加,在1329种药物中,有58种药物与早产风险有关. 这项研究优先考虑使用真实世界的数据在孕妇人群中进行药物安全研究.
科学领域:
- 药物监督 药物监督 药物监督
- 生殖健康 生殖健康
- 现实世界的证据.
背景情况:
- 孕妇在临床试验中代表性不足,导致药物安全性数据有限.
- 大多数孕妇使用药物,需要进行强有力的安全评估.
- 现有的现实世界数据可以提高对怀孕期间药物安全性的理解.
研究的目的:
- 在孕妇中描述药物使用模式.
- 应用倾向性得分与患者记录相匹配,用于大规模分析.
- 加快和优先检测与不良妊娠结果相关的药物效应,包括早产.
主要方法:
- 在2013年至2022年期间,对365,075名活产儿进行了回顾性研究.
- 对怀孕期间处方的门诊药物的分析,每种药物的最低样本大小为600个.
- 倾向性得分匹配用于调整人口统计,怀孕特征和并发症.
主要成果:
- 在2013年至2022年期间,处方药的处方率从58.5%增加到75.3% (P < 0.0001).
- 过早分娩的发生率为7.7%.
- 在分析的1329种药物中,58种药物与早产风险具有统计学意义的关联 (46种增加,12种减少).
结论:
- 现实数据和倾向分数匹配可以有效地识别怀孕期间潜在的药物风险.
- 这种方法优先考虑58种药物,以进一步调查早产风险.
- 该方法为研究其他妊娠结果和推进妊娠药理学提供了基础.
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