Pacqué M, Muñoz B, Poetschke G, Foose J, Greene B M, Taylor H R
Dana Center for Preventive Ophthalmology, Wilmer Institute, John Hopkins University, Baltimore, Maryland.
Lancet. 1990 Dec 15;336(8729):1486-9. doi: 10.1016/0140-6736(90)93187-t.
Ivermectin is the drug of choice for community-based treatment of onchocerciasis. Since pregnancy testing during mass distribution campaigns is not feasible, the safety of ivermectin in pregnancy must be established. During a 3-year study, ivermectin was distributed to the population of a rubber plantation (14,000 people) in Liberia. Only 31% of women were aware of their pregnancy status during the first month; it was calculated that about half of women in the first trimester of pregnancy are likely to be treated inadvertently. 203 children born to women inadvertently treated during pregnancy were identified. In this limited sample, there was no significant difference in birth defects between treated and untreated mothers in the same population or compared with a reference population. Children of treated and untreated mothers showed no difference in developmental status or disease patterns. Further surveillance is necessary; however, since no major effects of ivermectin on pregnancy outcome were detected, there seems no need to change existing strategies of ivermectin distribution.
伊维菌素是社区治疗盘尾丝虫病的首选药物。由于在大规模分发活动期间进行妊娠检测不可行，因此必须确定伊维菌素在孕期的安全性。在一项为期3年的研究中，伊维菌素被分发给利比里亚一个橡胶种植园的人群（14000人）。在第一个月，只有31%的女性知道自己的怀孕状况；据计算，大约一半处于妊娠早期的女性可能会在不知情的情况下接受治疗。研究确定了203名在孕期被无意治疗的女性所生的孩子。在这个有限的样本中，同一人群中接受治疗和未接受治疗的母亲所生孩子的出生缺陷没有显著差异，与参考人群相比也没有差异。接受治疗和未接受治疗的母亲的孩子在发育状况或疾病模式上没有差异。进一步的监测是必要的；然而，由于未检测到伊维菌素对妊娠结局有重大影响，似乎没有必要改变现有的伊维菌素分发策略。
