在怀孕和儿童神经发育期间使用抗药:基于人口的出生队列研究
Yongtai Cho1, Eun-Young Choi1,2, Jung Yeol Han3
1School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.
BMC medicine
|December 2, 2025
概括
这项研究发现,在怀孕期间使用抗药与儿童神经发育障碍之间没有显著的联系. 然而,某些特定暴露于甲托克洛普拉米德的风险略有增加,需要进一步研究.
科学领域:
- 产科和妇科 产科和妇科
- 儿科神经学 儿科神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 怀孕期间恶心和吐 (NVP) 影响高达80%的孕妇.
- 抗药通常被处方,但长期的神经发育效应尚未得到充分证实.
- 由于数据有限,需要评估暴露于怀孕抗药的儿童的神经发育障碍的风险.
研究的目的:
- 评估产前抗药物暴露与神经发育障碍和后代延迟之间的关联.
- 为怀孕期间使用抗药物提供基于证据的指导.
主要方法:
- 全国范围的队列研究使用韩国国家医疗保险服务数据库 (2009-2023年).
- 主要暴露:美托克洛普拉米德;二次暴露:皮里多克辛,多克西胺,二氨酸,多佩里,丹塞.
- 结果:七种神经发育障碍和延迟;使用Cox比例危险模型与重叠权重进行分析.
主要成果:
- 总体抗药物暴露与神经发育障碍/延迟之间没有发现实质性关联.
- 在怀孕晚期使用甲托克洛普拉米德时,ADHD的风险略高 (HR 1.12).
- 增加神经发育延迟的风险,暴露于甲托克洛普拉米德≥7天.
结论:
- 产前抗emetic暴露通常与神经发育障碍或延迟的风险增加无关.
- 研究结果为在管理NVP时使用抗药提供了保证.
- 在特定子组中略有增加的风险需要进一步调查,并为临床决策提供信息.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
790
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
790
Teratogenicity
3.9K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
3.9K
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
524
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
524
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
576
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
576
Drug Dosing: Infants and Children
234
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
234
Factors Affecting Drug Response: Overview
2.8K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.8K


