Slone Epidemiology Center at Boston University, Boston, Massachusetts.
Birth Defects Res. 2019 Nov 15;111(19):1479-1486. doi: 10.1002/bdr2.1563. Epub 2019 Aug 8.
Influenza during pregnancy contributes to maternal morbidity and mortality. Neuraminidase inhibitors, including oseltamivir, are recommended for treating women with influenza during pregnancy.
Data from the Slone Birth Defects Study from 2009 to 2015 were used to investigate associations between oseltamivir and specific birth defects. We classified exposures according to timing in pregnancy and examined 52 and 16 defects with early and potential late pregnancy etiology, respectively; we calculated crude odds ratios (ORs) and 95% confidence intervals (CIs) for defects with three or more exposures.
Among 8,379 cases and 4,190 nonmalformed controls, we identified 79 and 42 oseltamivir exposures, respectively. The majority of defects had no exposures. ORs were elevated for several defects, but the CI excluded the null only for intestinal malrotation (OR: 10.7 [1.8, 45.2]; three exposures).
Largely null findings for specific defects are reassuring. The association with intestinal malrotation, while unstable, warrants further investigation.
流感在孕期可导致孕产妇发病率和死亡率升高。神经氨酸酶抑制剂，包括奥司他韦，被推荐用于治疗孕期流感患者。
我们使用了 2009 年至 2015 年斯隆出生缺陷研究的数据，来调查奥司他韦与特定出生缺陷之间的关系。我们根据孕期时间对暴露情况进行分类，分别研究了 52 种和 16 种具有早期和潜在晚期病因的缺陷；我们计算了具有 3 种及以上暴露的缺陷的粗比值比（OR）和 95%置信区间（CI）。
在 8379 例病例和 4190 例非畸形对照中，我们分别确定了 79 例和 42 例奥司他韦暴露。大多数缺陷没有暴露。一些缺陷的 OR 升高，但 CI 仅排除了肠道旋转不良（OR：10.7[1.8，45.2]；三种暴露）的零假设。
对于特定缺陷的大量阴性结果令人安心。虽然与肠道旋转不良的关联不稳定，但仍需要进一步研究。
