孕前与正常怀孕的QTc间隔变化:系统性审查和元分析
Omar A Aboshady1,2, Jess Z Raffa1, Sara K Quinney1,3,4
1Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA.
Clinical pharmacology and therapeutics
|February 27, 2025
概括
怀孕会延长心率校正的QT (QTc) 间隔,而孕前会导致更大的QTc延长. 这突显了孕妇的潜在风险,特别是使用延长QT的药物时.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 怀孕显著改变了心脏自主神经系统.
- 孕前会给心脏带来额外的压力,可能会影响心室再极化.
- 正常怀孕和孕前对心率校正的QT (QTc) 间隔的影响尚不清楚,尽管使用了延长QT的药物.
研究的目的:
- 测量正常怀孕期间QTc间隔的变化,跨越三个月.
- 为了评估与正常怀孕相比,第三季度孕前的QTc间隔变化.
主要方法:
- 八个数据库的系统审查和元分析 (至2025年1月13日).
- 包括报告QT/QTc间隔和心率/RR间隔的研究在怀孕三季度或与非怀孕对照.
- 随机效应模型用于计算 QTc 间隔中的聚合平均差异.
主要成果:
- 分析包括33项研究,共有5,153名参与者.
- 与非怀孕个体相比,QTc间隔在第一 (10.0毫秒),第二 (20.2毫秒) 和第三 (23.0毫秒) 三季度显著增加.
- 与正常怀孕相比,第三季度的孕前症显示QTc间隔进一步增加21.7毫秒.
结论:
- 在正常怀孕期间会发生显著的QTc间隔延长.
- 孕前会加剧QTc间隔的延长在妊娠的第三季度.
- 预先怀孕症中心律失常的风险增加,特别是使用QT延长药物时,需要进一步调查.
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