Tornblad Institute, University of Lund, Lund, Sweden.
Drug Saf. 2011 Aug 1;34(8):691-703. doi: 10.2165/11590370-000000000-00000.
The use of drugs for migraine during pregnancy may have adverse effects on delivery outcome, and warnings exist for such drugs regarding use during pregnancy. Most information in the literature concerns triptans.
The aim of the study was to describe the delivery outcome when a woman had used drugs for migraine during pregnancy.
A register study where exposure for drugs was obtained partly by interview conducted by the attending antenatal care midwife and medical records from antenatal care (1995-2008) and partly by linkage to the Prescribed Drug Register (2005-8).
All deliveries in Sweden (1 211 670 women) recorded in the Medical Birth Register with data from antenatal care.
Women using triptans or ergots during pregnancy were identified and compared with all women who did not use drugs for migraine.
Pregnancy complications, pregnancy duration and birthweight, neonatal morbidity and mortality, and congenital malformations.
Use of ergots or triptans during early pregnancy (first trimester) occurred in 3286 women with 3327 infants, while use after the first trimester occurred in 1394 women with 1419 infants. Women using such drugs for migraine were older than other women, were more often of parity 1 (no previous infant) and more often had a high body mass index. Women using drugs for migraine had not previously had more miscarriages than expected. There was an increased risk for pre-eclampsia (odds ratio [OR] 1.44; 95% CI 1.17, 1.76). An increased risk for preterm birth was seen after use of drugs for migraine later in pregnancy (OR 1.50; 95% CI 1.22, 1.84). There was no increased risk for stillbirth or early neonatal death. No certain signs of teratogenicity were found for any of the drug types when compared with women not using such drugs (OR for any malformation 0.95; 95% CI 0.80, 1.12).
Our data suggest that the risk of adverse effects on pregnancy outcome associated with the use of drugs for migraine is low but data for triptans other than sumatriptan are still few.
怀孕期间使用偏头痛药物可能会对分娩结果产生不良影响，并且此类药物在怀孕期间的使用存在警告。文献中的大多数信息都涉及曲坦类药物。
本研究旨在描述女性怀孕期间使用偏头痛药物时的分娩结果。
这是一项注册研究，通过接受产前保健的助产士访谈和产前保健的医疗记录（1995-2008 年）以及与处方药物登记处的链接（2005-2008 年）部分获取药物暴露情况。
瑞典所有分娩（1211670 名女性）都记录在医疗分娩登记处，数据来自产前保健。
确定在怀孕期间使用曲坦类或麦角胺的女性，并与未使用偏头痛药物的所有女性进行比较。
妊娠并发症、妊娠持续时间和出生体重、新生儿发病率和死亡率以及先天性畸形。
在 3286 名孕妇（3327 名婴儿）中，有 3286 名孕妇在孕早期（第一孕期）使用麦角胺或曲坦类药物，而在 1394 名孕妇（1419 名婴儿）中，有 1394 名孕妇在孕早期后使用此类药物。使用偏头痛药物的女性年龄大于其他女性，更多的是初产妇（没有以前的婴儿），且体重指数更高。与预期相比，使用偏头痛药物的女性之前的流产次数并没有更多。子痫前期的风险增加（比值比 [OR] 1.44；95%置信区间 1.17，1.76）。妊娠后期使用偏头痛药物后早产的风险增加（OR 1.50；95%置信区间 1.22，1.84）。死产或新生儿早期死亡的风险没有增加。与未使用此类药物的女性相比，任何药物类型都没有发现致畸的明确迹象（任何畸形的 OR 0.95；95%置信区间 0.80，1.12）。
我们的数据表明，与使用偏头痛药物相关的妊娠结局不良风险较低，但曲坦类药物（除舒马曲坦外）的数据仍然较少。
