在第一季度对尿路感染和先天性形风险的抗生素使用
Sarah S Osmundson1, Katelin B Nickel2, Susan M Shortreed3,4
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|July 9, 2025
概括
第一个季度用于尿路感染 (UTI) 的抗生素使用显示,三甲-硫甲醇 (TMP-SMX) 与更高的先天性形风险有关. 与beta-lactams相比,尼托福兰和诺基诺没有显示增加的风险.
科学领域:
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
- 儿科 儿科 儿科
背景情况:
- 怀孕期间的尿路感染 (UTI) 需要抗生素治疗,因为可能会对母亲和新生儿造成严重后果.
- 有限且不一致的证据表明,第一季度抗生素暴露与先天性形之间存在关联.
研究的目的:
- 为了比较婴儿在第一季度暴露于用于治疗尿路感染的不同类型抗生素后的先天性形风险.
- 为了评估尼托福兰,三甲-硫甲 (TMP-SMX),诺基诺和β-乳酸在产性方面的安全性.
主要方法:
- 使用Merative MarketScan商业数据库 (2006-2022) 进行基于人口的队列研究.
- 包括15-49岁的孕妇接受了尿路感染治疗,与相关的活产婴儿.
- 使用经过验证的诊断代码算法识别的先天性形;用于估计风险的倾向性得分加权的逻辑二项式回归.
主要成果:
- 这项研究分析了71604例暴露于各种抗生素的孕妇.
- 与β-lactams相比,甲-硫法佐 (TMP-SMX) 暴露与任何先天性形的更高风险有关 (RR, 1.35).
- TMP-SMX与心脏形和口唇裂风险的增加有关,而酸黄和诺基诺没有显著增加整体形风险.
结论:
- 第一个三个月的TMP-SMX用于尿路感染可能与某些先天性形的风险增加有关.
- 与β-乳糖类相比,在怀孕早期使用尼托福兰没有显示出发育不良的风险增加.
- 需要进一步的研究来澄清在怀孕早期与特定抗生素暴露相关的风险.
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