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甲型 H1N1 流感流行期间使用奥司他韦治疗流感的孕妇所生婴儿结局。

Infant outcomes among pregnant women who used oseltamivir for treatment of influenza during the H1N1 epidemic.

机构信息

OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada.

出版信息

Am J Obstet Gynecol. 2013 Apr;208(4):293.e1-7. doi: 10.1016/j.ajog.2013.01.015. Epub 2013 Jan 17.

Abstract

OBJECTIVE

This study was undertaken to examine the association between maternal oseltamivir treatment for influenza and infant outcomes during the 2009 HINI influenza pandemic.

STUDY DESIGN

This was a retrospective cohort study using a population-based maternal newborn database including women who gave birth to a singleton infant in the Canadian province of Ontario from November 2009 through April 2010. Risks of small for gestational age (SGA) (10th percentile and 3rd percentile), preterm birth (<37 weeks of gestation), very preterm birth (<32 weeks of gestation), and 5-minute Apgar score <7 associated with maternal exposure to oseltamivir were analyzed by multivariable regression.

RESULTS

A total of 55,355 women with a singleton birth were included in this study. Among them, 1237 (2.2%) women received oseltamivir for treatment or prevention of influenza during pregnancy. Women who took oseltamivir during pregnancy were less likely to have a SGA infant based on the 10th percentile for growth (adjusted risk ratio, 0.77; 95% confidence interval, 0.60-0.98). No association between maternal use of oseltamivir with SGA on 3rd percentile, preterm birth, very preterm birth, and low Apgar score was observed.

CONCLUSION

There is no evidence of an association between maternal use of oseltamivir for influenza and early birth, low Apgar at birth, and poor fetal growth.

摘要

目的

本研究旨在探讨 2009 年 H1N1 流感大流行期间母亲接受奥司他韦治疗流感与婴儿结局之间的关系。

研究设计

这是一项回顾性队列研究,使用基于人群的产妇-新生儿数据库,纳入了 2009 年 11 月至 2010 年 4 月期间在加拿大安大略省分娩单胎婴儿的女性。通过多变量回归分析母亲暴露于奥司他韦与小于胎龄儿(SGA)(第 10 百分位数和第 3 百分位数)、早产(<37 孕周)、极早产(<32 孕周)和 5 分钟 Apgar 评分<7 的风险之间的关系。

结果

共有 55355 名女性分娩单胎,其中 1237 名(2.2%)女性在孕期接受奥司他韦治疗或预防流感。与未接受奥司他韦治疗的女性相比,孕期接受奥司他韦治疗的女性婴儿 SGA 发生率较低(基于第 10 百分位数的生长,调整风险比为 0.77;95%置信区间为 0.60-0.98)。母亲使用奥司他韦与 SGA 第 3 百分位数、早产、极早产和低 Apgar 评分之间没有关联。

结论

没有证据表明母亲使用奥司他韦治疗流感与早期分娩、出生时低 Apgar 评分和胎儿生长不良之间存在关联。

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