Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (Clintec), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
J Thromb Haemost. 2014 Dec;12(12):1986-92. doi: 10.1111/jth.12757. Epub 2014 Nov 14.
Selective serotonin reuptake inhibitors (SSRIs) are known to increase the risk of gastrointestinal bleeding.
Study the risk of bleeding-related complications in relation to SSRI in pregnancy.
PATIENTS/METHODS: This was a hospital-based cohort study. All women who gave birth at Karolinska University Hospital in Stockholm over a 5-year period (2007 to 2011) were included in the study. Those women who the electronic maternal health record indicated were using SSRI (n = 500) were considered exposed, and all other women formed a control population (n = 39,594). The main outcome measures were blood loss, postpartum hemorrhage (PPH), PP anemia and length of hospitalization.
The absolute risk of PPH and PP anemia for the 1.2% exposed to SSRI were 18.0% and 12.8%, respectively. Women with a vaginal non-surgical delivery who reported use of SSRI during pregnancy had approximately a 2-fold increased risk of both PPH (OR, 2.6; 95% CI, 2.0-3.5) and PP anemia (OR, 2.1; 95% CI, 1.5-2.9), as compared with controls. Blood loss and length of hospitalization were significantly higher among women using SSRI than non-users (arithmetic mean 484 mL vs. 398 mL, 3.8 days vs. 2.4 days, respectively).
The use of SSRI during pregnancy increases blood loss and doubles the risk of PPH and PP anemia in a setting where SSRI had not been considered a risk factor for increased blood loss. Because PPH is a leading cause of maternal mortality and morbidity, the awareness of bleeding-related complications is important, both in relation to pregnancy and to surgery in general.
选择性 5-羟色胺再摄取抑制剂（SSRIs）已知会增加胃肠道出血的风险。
研究与妊娠期间 SSRIs 相关的出血相关并发症的风险。
患者/方法：这是一项基于医院的队列研究。所有在斯德哥尔摩卡罗林斯卡大学医院分娩的女性（2007 年至 2011 年）均被纳入研究。电子产妇健康记录显示正在使用 SSRIs 的女性（n = 500）被认为是暴露组，而所有其他女性则构成对照组（n = 39594）。主要结局指标是出血量、产后出血（PPH）、PP 贫血和住院时间。
暴露于 SSRIs 的 1.2%的女性发生 PPH 和 PP 贫血的绝对风险分别为 18.0%和 12.8%。报告在怀孕期间使用 SSRIs 的阴道非手术分娩女性，发生 PPH（OR，2.6；95%CI，2.0-3.5）和 PP 贫血（OR，2.1；95%CI，1.5-2.9）的风险几乎增加了两倍与对照组相比。与非使用者相比，使用 SSRIs 的女性出血量和住院时间明显更高（算术平均值分别为 484 mL 和 398 mL，3.8 天和 2.4 天）。
在未将 SSRIs 视为增加出血量的危险因素的情况下，妊娠期间使用 SSRIs 会增加出血量，并使 PPH 和 PP 贫血的风险增加一倍。由于 PPH 是孕产妇死亡和发病率的主要原因，因此，无论是与妊娠相关还是与一般手术相关，都需要意识到出血相关并发症的重要性。
