怀孕期间暴露于全身抗菌药物和流产风险:基于人口的注册研究
Thomas Boissiere-O'Neill1,2, Marleen M H J van Gelder2, Hilde M Engjom3
1Child Health Research Centre, The Children's Health and Environment Program, The University of Queensland, Brisbane, QLD, Australia.
概括
在怀孕早期,尼托福兰,皮夫梅基林纳姆和阿莫西西林是安全的. 然而,其他一些抗微生物药物可能会增加流产风险,潜在的感染可能会影响这些关联.
科学领域:
- 生殖健康 生殖健康
- 药物监督 药物监督 药物监督
- 流行病学 流行病学
背景情况:
- 关于早期怀孕和流产风险的抗微生物药物使用的先前研究受到偏见的限制.
- 准确的风险评估对于明智的临床决策至关重要.
研究的目的:
- 为了估计妊娠期抗微生物药物暴露后流产风险.
- 解决和减轻先前研究中存在的偏见.
主要方法:
- 一项基于人口的队列研究,利用挪威 (2009-2018) 的全国性链接注册表.
- 包括704,082例怀孕,其中91,836例暴露于全身抗微生物药物.
- 采用时间分层的考克斯回归与重叠权重,考虑时间变化的暴露,反向因果关系,并根据指示混.
主要成果:
- 尼托福兰,皮夫梅基林纳姆和阿莫西西林没有增加流产风险.
- 甲尼达,西普罗夫洛克萨,塞法列辛,可纳和三甲硫与流产风险增加有关.
- 概率偏差分析表明潜在的感染可能解释了常见抗微生物药物的关联.
结论:
- 某些抗微生物药物,如尼托福兰,皮夫梅基林和阿莫西西林,不会增加流产的风险.
- 不太常见的抗微生物药物可能会带来更高的风险,需要仔细考虑.
- 这项研究通过解决关键偏见,提供了更可靠的孕期抗菌药物风险评估.
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