Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
Asia Pac Psychiatry. 2018 Sep;10(3):e12309. doi: 10.1111/appy.12309. Epub 2018 Jan 3.
To examine (1) if the use of benzodiazepines and antidepressants during pregnancy may increase the risk of preterm birth and/or low birth weight (LBW), and, if yes, (2) which types of benzodiazepines or antidepressants have stronger influences.
A case-control study was performed using a large claims database in Japan. Cases were mothers who had given birth to preterm and/or LBW infants between 2005 and 2014 (737 with preterm births and 1615 with LBW). Controls were mothers who had neither experienced preterm birth nor given birth to an LBW infant.
Overall, 42 058 births were included. The maternal use of benzodiazepines was significantly associated with an increased risk of preterm birth (adjusted odds ratio [OR], 2.03; 95% confidence interval [CI], 1.11-3.69, P < .05), while the maternal use of benzodiazepines was not significantly associated with LBW (adjusted OR, 1.55; 0.96-2.50). The use of antidepressants was not significantly associated with both preterm deliveries (adjusted OR, 0.57; 0.08-4.16) and LBW (adjusted OR, 0.56; 0.14-2.29).
Benzodiazepine use was associated with increased risk of preterm birth but not with LBW. Antidepressant use was not associated with both preterm deliveries and LBW.
考察(1)妊娠期间使用苯二氮䓬类药物和抗抑郁药是否会增加早产和/或低出生体重(LBW)的风险,如果是,(2)哪种类型的苯二氮䓬类药物或抗抑郁药的影响更大。
在日本一个大型理赔数据库中进行了病例对照研究。病例组为 2005 年至 2014 年间分娩早产儿和/或 LBW 婴儿的母亲(737 例早产,1615 例 LBW)。对照组为既未经历早产也未分娩 LBW 婴儿的母亲。
共纳入 42058 例分娩。母亲使用苯二氮䓬类药物与早产风险增加显著相关(调整后的优势比[OR],2.03;95%置信区间[CI],1.11-3.69,P<.05),而母亲使用苯二氮䓬类药物与 LBW 无关(调整后的 OR,1.55;0.96-2.50)。抗抑郁药的使用与早产(调整后的 OR,0.57;0.08-4.16)和 LBW(调整后的 OR,0.56;0.14-2.29)均无显著相关性。
苯二氮䓬类药物的使用与早产风险增加有关,但与 LBW 无关。抗抑郁药的使用与早产和 LBW 均无相关性。