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在怀孕期间使用多西环素的安全性:
Itamar Ben Shitrit1,2, Daphna Idan1,2, Ariel Avraham Hassidim3,4
1Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel.
Infection
|August 22, 2025
概括
怀孕期间使用多西环素与严重的出生缺陷无关. 虽然第三个月的暴露显示出更高的出生体重的风险,但当多西环林在医学上必要时,胎儿的整体安全性似乎是有利的.
科学领域:
- 产科和妇科
- 药理学
- 胎儿医学
背景情况:
- 在怀孕期间常用多西环素,但其对胎儿的安全性数据不一致.
- 现有的研究往往不包括活产,限制了全面的安全评估.
研究的目的:
- 评估第一或第三季度多西环素暴露与重大先天性形之间的关联.
- 评估多西环素暴露与妊娠晚期不良结果之间的联系,包括死产和终止.
主要方法:
- 从1998年至2017年对265,686例怀孕的基于人口的队列研究.
- 通过药房记录确定了第一个 (≤13周) 和第三个 (≥27周) 三季度的多西环素暴露.
- 负二项模型估计了生育不良和围产期结局的相对风险;敏感性分析包括剂量反应和倾向性得分的匹配.
主要成果:
- 第一个三个月的多西环素暴露 (n=2,696) 与重大先天性形没有显著的关联 (调整后RR=1. 07;95% CI为0. 93-1. 23).
- 没有观察到器官特异性形或大多数晚期妊娠结局的风险增加.
- 第三个月的暴露 (n=112) 与出生时体重非常低的风险更高.
结论:
- 在怀孕期间使用多西环素并没有增加重大先天性形的风险.
- 大多数怀孕后期的不良结果不受多西环素暴露的影响.
- 这些发现表明,当在怀孕期间临床指示时,多西环素可以被认为是相对安全的.
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