妊娠早期使用醋酸格拉替雷:一项前瞻性队列研究。
Glatiramer acetate during early pregnancy: A prospective cohort study.
作者信息
Herbstritt Sandra, Langer-Gould Annette, Rockhoff Milena, Haghikia Aiden, Queisser-Wahrendorf Annette, Gold Ralf, Hellwig Kerstin
机构信息
Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany/Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Duesseldorf, Germany.
Kaiser Permanente Southern California, Pasadena, CA, USA.
出版信息
Mult Scler. 2016 May;22(6):810-6. doi: 10.1177/1352458515623366. Epub 2016 Jan 11.
BACKGROUND
Only limited data are available on whether glatiramer acetate exposure during pregnancy has an effect on perinatal outcome.
OBJECTIVE
To determine the effect of glatiramer acetate exposure during pregnancy on pregnancy outcomes in women with multiple sclerosis.
METHODS
We compared the outcome of pregnancies of women with multiple sclerosis exposed to glatiramer acetate with pregnancies unexposed to disease-modifying therapies. Women were enrolled into the German Multiple Sclerosis and Pregnancy registry. A standardized questionnaire was administered during pregnancy and postpartum. Detailed information on course of multiple sclerosis and pregnancy, concomitant medications, labor, delivery, and outcome of pregnancy was obtained.
RESULTS
We collected data on 246 multiple sclerosis pregnancies, 151 exposed to glatiramer acetate and 95 unexposed to disease-modifying therapies during pregnancy. Three (2.2%) congenital anomalies occurred in the exposed and 6 (6.7%) in the control group. We did not observe an increase in other adverse pregnancy or delivery outcomes including spontaneous abortions, preterm birth, Cesarean sections, or reduced birth weight in the exposed group.
CONCLUSION
Our data provide further evidence that glatiramer acetate exposure during the first trimester of pregnancy appears safe and without teratogenic effect. These findings provide important additive knowledge to better counsel women with multiple sclerosis in planning a pregnancy.
背景
关于孕期使用醋酸格拉替雷是否会对围产期结局产生影响,目前仅有有限的数据。
目的
确定孕期使用醋酸格拉替雷对多发性硬化症女性妊娠结局的影响。
方法
我们比较了暴露于醋酸格拉替雷的多发性硬化症女性的妊娠结局与未接受疾病修正治疗的妊娠结局。女性被纳入德国多发性硬化症与妊娠登记处。在孕期和产后进行标准化问卷调查。获取了关于多发性硬化症病程、妊娠情况、伴随用药、分娩、生产及妊娠结局的详细信息。
结果
我们收集了246例多发性硬化症妊娠的数据,其中151例在孕期暴露于醋酸格拉替雷,95例未接受疾病修正治疗。暴露组发生3例(2.2%)先天性异常,对照组发生6例(6.7%)。我们未观察到暴露组其他不良妊娠或分娩结局增加,包括自然流产、早产、剖宫产或出生体重降低。
结论
我们的数据进一步证明,孕期头三个月暴露于醋酸格拉替雷似乎是安全的,且无致畸作用。这些发现为更好地为计划怀孕的多发性硬化症女性提供咨询提供了重要的补充知识。