Fältmarch Stella, Perttilä Iiro, Tuomi Ulla, Kautiainen Hannu, Gissler Mika, Pennanen Pirjo, Eriksson Johan G, Laine Merja K
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Pharmacy of Palokka, Jyväskylä, Finland.
Pharmacoepidemiol Drug Saf. 2019 Sep;28(9):1239-1245. doi: 10.1002/pds.4848. Epub 2019 Jul 9.
To evaluate the use of opioids in pregnant primiparous women and study the effect of opioid use on maternal and offspring delivery outcomes.
The study cohort (N = 6231) consists of all primiparous women with a Finnish background who delivered a singleton between 2009 and 2015 in the city of Vantaa, Finland. Data on births, maternal characteristics, pregnancy outcomes, and purchases of prescription drugs were obtained from National Health Registers.
Of the primiparous women, 5.1% used opioids during pregnancy. Of these, 95.9% used codeine. No differences were observed in purchases of opioids between the different trimesters but more women purchased opioids as pregnancy progressed (.002). Users of opioids more often also purchased other prescription drugs compared with non-users of opioids, 89% versus 58% (P < .001); age, smoking, education, and body mass index adjusted odds ratio 5.66 (95% confidence interval 3.96 to 8.09). Caesarean sections were more common in users of opioids than in non-users, 28.3% versus 21.9% (.007). Before the age of 7 days, the offspring of users of opioids more often needed respirator treatment compared with the offspring of non-users, 3.1% versus 1.6% (.044).
One out of 20 pregnant women used opioids. Use of opioids during pregnancy was associated with the risk for deliveries by caesarean sections and need for respiratory treatment among the offspring during the first week of life. Further safety evaluations are needed.
评估阿片类药物在初产妇中的使用情况，并研究阿片类药物使用对母婴分娩结局的影响。
研究队列（N = 6231）由所有具有芬兰背景、于2009年至2015年在芬兰万塔市分娩单胎的初产妇组成。出生、产妇特征、妊娠结局和处方药购买数据来自国家卫生登记处。
在初产妇中，5.1%在孕期使用阿片类药物。其中，95.9%使用可待因。不同孕期之间阿片类药物购买情况无差异，但随着孕期进展，购买阿片类药物的女性增多（P = 0.002）。与未使用阿片类药物的女性相比，阿片类药物使用者更常购买其他处方药，比例分别为89%和58%（P < 0.001）；年龄、吸烟、教育程度和体重指数调整后的优势比为5.66（95%置信区间3.96至8.09）。阿片类药物使用者剖宫产更为常见，比例分别为28.3%和21.9%（P = 0.007）。与未使用者的后代相比，阿片类药物使用者的后代在出生7天前更常需要呼吸治疗，比例分别为3.1%和1.6%（P = 0.044）。
每20名孕妇中有1人使用阿片类药物。孕期使用阿片类药物与剖宫产风险以及出生后第一周内后代需要呼吸治疗有关。需要进一步进行安全性评估。
