Bolin Elijah H, Escalona-Vargas Diana, Daily Joshua A, Siegel Eric R, Lowery Curtis L, Coker Jessica, Stowe Zachary N, Eswaran Hari
Department of Pediatrics, Division of Cardiology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
J Obstet Gynaecol Res. 2019 Oct;45(10):1989-1996. doi: 10.1111/jog.14055. Epub 2019 Jul 11.
Pregnant women undergoing treatment for opioid use disorder (OUD) may be exposed to multiple QT prolonging agents. We used magnetocardiography to measure fetal QT intervals in mothers with OUD on buprenorphine therapy.
Fetal and maternal magnetocardiography was performed in pregnant women receiving buprenorphine-assisted treatment (Disorder group); these were matched by gestational age to pregnant women who were opiate naïve (Reference group). Corrected QT intervals were determined using Bazett's formula and compared between groups.
A total of eight women in the Disorder group matched to eight in the Reference group. Seven of the mothers (88%) in the Disorder group were smokers; there were no smokers in the Reference group. The average fetal corrected QT was significantly longer (P = 0.022) in the Disorder group than that in the Reference group (505 milliseconds [ms] ± 68.6 [standard deviation] vs 383 ms ± 70.3 [standard deviation]).
Novel data from this small sample demonstrate prolongation of fetal corrected QT in women with OUD participating in buprenorphine assisted therapy. Additional investigation from a larger sample is needed to clarify if fetal buprenorphine and/or tobacco exposure is associated with changes in fetal QT which would warrant further prenatal and postnatal testing.
接受阿片类物质使用障碍(OUD)治疗的孕妇可能会接触到多种可延长QT间期的药物。我们使用磁心动图来测量接受丁丙诺啡治疗的患有OUD的母亲的胎儿QT间期。
对接受丁丙诺啡辅助治疗的孕妇(疾病组)进行胎儿和母亲的磁心动图检查;这些孕妇按孕周与未使用阿片类药物的孕妇(参照组)进行匹配。使用巴泽特公式确定校正QT间期,并在两组之间进行比较。
疾病组共有8名女性与参照组的8名女性匹配。疾病组中有7名母亲(88%)吸烟;参照组中无吸烟者。疾病组胎儿的平均校正QT明显长于参照组(P = 0.022)(505毫秒[ms]±68.6[标准差]对383 ms±70.3[标准差])。
这个小样本的新数据表明,参与丁丙诺啡辅助治疗的患有OUD的女性胎儿校正QT延长。需要从更大的样本进行进一步调查,以阐明胎儿丁丙诺啡和/或烟草暴露是否与胎儿QT的变化有关,这将需要进一步的产前和产后检测。