孕期使用减充血剂及其与早产的关联。
Decongestant use during pregnancy and its association with preterm delivery.
作者信息
Hernandez Rohini K, Mitchell Allen A, Werler Martha M
机构信息
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts 02118, USA.
出版信息
Birth Defects Res A Clin Mol Teratol. 2010 Sep;88(9):715-21. doi: 10.1002/bdra.20699.
BACKGROUND
Despite the frequent intake of decongestants during pregnancy, only one study to date has evaluated the association of decongestants with preterm delivery, and it identified a reduced risk. We examined this association in more detail.
METHODS
Using a population-based random sample of 3271 Massachusetts live-born births without major malformations, we categorized decongestant exposure according to timing, frequency of use, route, and indication. Preterm birth was defined as a gestational age of <37 completed weeks. We estimated hazard ratios and examined confounding by indication by examining various strata of women and through multivariate adjustment.
RESULTS
Compared to nonexposed women, those who took decongestants during the second or third trimester only were less likely to experience preterm delivery (HR, 0.42; 95% CI, 0.21-0.84). This association was observed only for women without preeclampsia.
CONCLUSIONS
A protective association between decongestant use and preterm delivery has now been observed in two studies; however, the possibility of confounding by underlying condition remains.
背景
尽管孕期经常使用减充血剂，但迄今为止只有一项研究评估了减充血剂与早产之间的关联，且该研究发现风险降低。我们更详细地研究了这种关联。
方法
我们以马萨诸塞州3271例无重大畸形的活产婴儿为基于人群的随机样本，根据使用时间、使用频率、途径和指征对减充血剂暴露进行分类。早产定义为孕周小于37足周。我们估计了风险比，并通过检查不同层次的女性以及进行多变量调整来检验指征性混杂因素。
结果
与未暴露的女性相比，仅在孕中期或孕晚期使用减充血剂的女性早产的可能性较小（风险比，0.42；95%置信区间，0.21 - 0.84）。这种关联仅在无先兆子痫的女性中观察到。
结论
两项研究现已观察到使用减充血剂与早产之间存在保护性关联；然而，潜在疾病导致混杂的可能性仍然存在。
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