Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Pharmacoepidemiol Drug Saf. 2010 Apr;19(4):418-27. doi: 10.1002/pds.1915.
(1) Measure the prevalence and trends of anti-infective drug use before, during, and after pregnancy; (2) to list the doses, classes, types, and indications for anti-infective use during pregnancy; and (3) to identify predictors associated with anti-infective drug use during pregnancy.
Retrospective cohort study within the Quebec Pregnancy Registry, which was created by the linkage of three administrative databases: RAMQ, Méd-Echo, and ISQ. Women were eligible if they were (1) continuously insured by the RAMQ drug plan for at least 12 months before the first day of gestation, during pregnancy and 12 months after the end of the pregnancy and (2) if they gave birth to a live born between January 1998 and December 2003. Ninety-seven thousand six hundred and eighty pregnant women met the eligibility criteria. Data were collected for systemic agents. Logistic regression models were used to quantify predictors of use.
Prevalence of anti-infective use during pregnancy was 24.5%. Penicillins use increased compared to other classes. The most frequently diagnosed infections were respiratory and urinary tract infections. Predictors associated with use at the beginning of gestation were having > or =2 different prescribers [OR = 3.83 (95% confidence interval 95%CI: 3.3-4.3)], diagnosis of urinary [OR = 1.50 (95%CI: 1.3-1.8)], and respiratory tract infection [OR = 1.40 (95%CI: 1.2-1.6)] in the year before pregnancy. Visits to an obstetrician/gynecologist were protective for use [OR = 0.81 (95%CI: 0.67-0.97)].
Anti-infective use during pregnancy is prevalent. The oldest and safest agents are preferred.
(1) 测量妊娠前、妊娠期间和妊娠后抗感染药物的使用情况和趋势；(2) 列出妊娠期间抗感染药物的剂量、类别、类型和适应证；(3) 确定与妊娠期间使用抗感染药物相关的预测因素。
这项在魁北克妊娠登记处进行的回顾性队列研究，通过将三个行政数据库（RAMQ、Méd-Echo 和 ISQ）进行链接而建立。如果女性符合以下条件，则有资格参与研究：(1) 在妊娠第一天前至少连续 12 个月通过 RAMQ 药物计划投保，在妊娠期间和妊娠结束后 12 个月内投保，(2) 她们在 1998 年 1 月至 2003 年 12 月期间分娩出活产婴儿。97680 名孕妇符合资格标准。收集了全身药物的数据。使用逻辑回归模型来量化使用的预测因素。
妊娠期间抗感染药物的使用比例为 24.5%。与其他类别相比，青霉素的使用有所增加。最常见的诊断感染是呼吸道和尿路感染。妊娠早期使用的预测因素包括有≥2 位不同的处方医生[比值比 (OR) = 3.83（95%置信区间 95%CI：3.3-4.3)]、妊娠前一年诊断出尿路[OR = 1.50（95%CI：1.3-1.8)]和呼吸道感染[OR = 1.40（95%CI：1.2-1.6)]。看妇产科医生的就诊次数对抗生素的使用有保护作用[OR = 0.81（95%CI：0.67-0.97)]。
妊娠期间抗感染药物的使用较为普遍。首选最古老和最安全的药物。
