心理药物治疗和产后出血之间存在关联
Frank I Jackson1,2,3, Insaf Kouba1,2,3, Natalie Meirowitz1,3,4
1Northwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
AJOG global reports
|November 8, 2024
概括
产前心理药物治疗 (PPT) 的使用与需要输血的产后出血 (PPH) 的风险更高有关. 组合PPT疗法与PPH的相关性比单一疗法更大.
科学领域:
- 产科和妇科 产科和妇科
- 围产期心理健康 围产期心理健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于心理药物治疗 (PPT) 和产后出血 (PPH) 之间的联系存在不一致的发现.
- 澄清这种关系对于患者咨询和风险评估至关重要.
- 这项研究调查了产前PPT暴露和需要输血的PPH之间的关联.
研究的目的:
- 评估产前PPT暴露与需要输血红细胞 (PPH+pRBC) 的PPH之间的关联.
- 检查个人PPT药物类与PPH+pRBC之间的联系.
- 评估心理健康治疗强度与PPH+pRBC之间的关联.
主要方法:
- 在2019年1月至2022年12月期间,对107425次交付进行了回顾性横截面研究.
- 对各种精神药物产前暴露的分析,包括SSRI,SNRIs,二zepines和其他药物.
- 多变量逻辑回归调整为已知的出血风险因素.
主要成果:
- 产前PPT暴露发生在3.6%的怀孕中,PPH+pRBC率为5.5%,而未暴露的怀孕中为2.8% (aOR 2.10).
- 单独治疗SSRI和二二类药物与增加PPH+pRBC几率有关.
- 与单一治疗和不使用PPT相比,组合PPT与PPH+pRBC (aOR 3.96) 的几率明显更高.
结论:
- 产前心理药物治疗暴露与临床显著的产后出血需要输血的几率增加有关.
- 与单一治疗相比,组合疗法与PPH+pRBC的相关性更强.
- 这些发现强调了对使用心理药物的孕妇进行谨慎的风险益处评估的重要性.
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