Martel Marie-Josée, Rey Evelyne, Beauchesne Marie-France, Perreault Sylvie, Forget Amélie, Maghni Karim, Lefebvre Geneviève, Blais Lucie
Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada.
J Allergy Clin Immunol. 2007 Mar;119(3):576-82. doi: 10.1016/j.jaci.2006.10.034. Epub 2006 Dec 12.
The effect of inhaled short-acting beta(2)-agonists (SABAs) on pregnancy outcome, especially hypertensive complications, is not well documented. After the finding of a possible protective association of inhaled SABAs with pregnancy-induced hypertension (PIH) in a previous study, we decided to further investigate their effect on this condition.
We sought to determine the effect of inhaled SABA use during pregnancy on the risk of PIH (gestational hypertension, preeclampsia, or eclampsia) in asthmatic women.
Three of Quebec's administrative databases were linked to constitute a cohort of asthmatic women who had at least 1 delivery between 1990 and 2000. A nested case-control study was performed using up to 10 control subjects matched to each case patient for the year of conception and gestational age. Statistical analyses considered 22 confounders.
The cohort was composed of 3505 asthmatic women who had a total of 4593 pregnancies. Three hundred two patients with PIH and 3013 control subjects were identified. Compared with nonuse, inhaled SABA use during pregnancy was significantly associated with a reduced risk of PIH (adjusted rate ratios: >0-3 doses/week, 0.62 (95% CI, 0.44-0.87); > 3-10 doses/week, 0.51 (95% CI, 0.34-0.79); and >10 doses/week, 0.48 (95% CI, 0.30-0.75)).
To our knowledge, this is the first study reporting that inhaled SABA use during pregnancy is associated with a reduced risk of PIH. Potential explanations include pharmacologic and physiological effects or residual confounding.
These results increase the evidence about the safety of inhaled SABAs in this population, although they should not undervalue the importance of maintaining good control of asthma symptoms.
吸入性短效β2 激动剂（SABA）对妊娠结局，尤其是高血压并发症的影响，目前尚无充分记录。在之前的一项研究发现吸入性 SABA 与妊娠高血压（PIH）可能存在保护性关联后，我们决定进一步研究其对这种情况的影响。
我们试图确定孕期使用吸入性 SABA 对哮喘女性患 PIH（妊娠期高血压、先兆子痫或子痫）风险的影响。
将魁北克的三个行政数据库相链接，以构成一个在 1990 年至 2000 年间至少有 1 次分娩的哮喘女性队列。进行了一项巢式病例对照研究，为每位病例患者匹配最多 10 名对照受试者，匹配条件为受孕年份和孕周。统计分析考虑了 22 个混杂因素。
该队列由 3505 名哮喘女性组成，她们总共怀孕 4593 次。确定了 302 例 PIH 患者和 3013 名对照受试者。与未使用相比，孕期使用吸入性 SABA 与 PIH 风险降低显著相关（调整后的率比：每周>0 - 3 剂，0.62（95%CI，0.44 - 0.87）；每周>3 - 10 剂，0.51（95%CI，0.34 - 0.79）；每周>10 剂，0.48（95%CI，0.30 - 0.75））。
据我们所知，这是第一项报告孕期使用吸入性 SABA 与 PIH 风险降低相关的研究。可能的解释包括药理和生理作用或残余混杂因素。
这些结果增加了关于吸入性 SABA 在该人群中安全性的证据，尽管不应低估维持哮喘症状良好控制的重要性。
