围产期药理疗法与极度早产婴儿的自发性肠道穿孔之间的关联:一种倾向性得分匹配研究
Wei-Hsin Cheng1, Lo-Hsuan Tu1, Ming-Chou Chiang1,2,3
1School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Children (Basel, Switzerland)
|February 26, 2025
概括
这项研究发现,产后皮和联合内类药物增加了极低出生体重 (ELBW) 婴儿自发肠穿孔 (SIP) 的风险. 临床医生应密切监测ELBW婴儿,当这些药物被管理.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 围产期药物与极低出生体重 (ELBW) 婴儿的自发肠孔 (SIP) 之间的关联尚未得到充分证实.
- 以前的研究由于回顾性设计和潜在的偏见而存在局限性.
- 倾向分数匹配 (PSM) 可以帮助减少分析药物效应的偏见.
研究的目的:
- 调查围产期药理学药剂对ELBW婴儿SIP的影响.
- 通过强大的统计方法来澄清与特定药物相关的风险.
- 为临床实践提供基于证据的指导,关于ELBW婴儿的药物使用.
主要方法:
- 在2014-2023年期间对ELBW婴儿 (<1000克) 的回顾性审查.
- 自发肠道穿孔 (SIP) 病例的识别和确认.
- 倾向性得分匹配 (PSM) 在SIP病例与对照病例的1:3比率上,考虑妊娠年龄,出生体重,性别和出生年份.
主要成果:
- 在858名ELBW婴儿中,发现了28例SIP病例,并与84名对照进行了匹配.
- 在SIP病例中,水皮质 (25%对9.5%) 和结合性无otropic药物 (17.9%对2.4%) 的使用率显著更高.
- 后勤回归确定了皮质 (OR 3.4) 和结合的内类药物 (OR 2.1) 作为SIP的独立风险因素.
结论:
- 这项PSM研究是第一个将产后皮和联合异能药物使用与ELBW婴儿SIP风险增加联系起来的研究.
- 皮和联合异类药物被确定为SIP的独立风险因素.
- 由于SIP风险增加,临床医生在给ELBW婴儿服用这些药物时必须谨慎和警.
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