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围产期用药安全性研究

[Study on the Safety of Perinatal Medication].

作者信息

Obara Taku

机构信息

Department of Pharmaceutical Sciences, Tohoku University.

Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine.

出版信息

Yakugaku Zasshi. 2021;141(4):463-471. doi: 10.1248/yakushi.20-00184.

Abstract

We have been conducting research with the aim of generating evidence for the safety of perinatal drugs. As a result of reviewing the records of inquiries to the Drug Information Office of our hospital, we found a large discrepancy between the description of perinatal drugs in package inserts in Japan and the description of the Pregnancy Risk Category according to the U.S. Food and Drug Administration. In the Japan Environment and Children's Study (JECS), we determined the proportion of drug and supplement use among 97464 pregnant women. We clarified that prescriptions of antihypertensive drugs for pregnant women increased during the second half of pregnancy, while prescriptions of anti-epileptic and anti-anxiety drugs decreased after pregnancy using a claims database. A survey of pharmacists and pharmacy students revealed a lack of awareness of effective folic acid intake to reduce the risk of neural tube defects in infants. The percentage of pre-pregnancy folic acid supplementation among pregnant women participating in the Babies and their Parents' Longitudinal Observation in Suzuki Memorial Hospital on Intrauterine Period (BOSHI) study, the JECS, and the Tohoku Medical Megabank (TMM) Birth and Three-Generation (BirThree) cohort study was 6.3-18.0%. As a result of close examination of the records of inquiries to the Drug Information Office of our hospital, and of cases in which our lactation plan sheet was applied, it was found that there were discrepancies between the information on the drug package insert and the information on Medications & Mother's Milk, etc. in Japan. The results obtained have been clinically applied in daily practice and we are continuing our research while taking measures.

摘要

我们一直在进行研究,目的是为围产期药物的安全性提供证据。通过审查我院药物信息办公室的咨询记录,我们发现日本药品说明书中围产期药物的描述与美国食品药品监督管理局的妊娠风险分类描述之间存在很大差异。在日本环境与儿童研究(JECS)中,我们确定了97464名孕妇中药物和补充剂的使用比例。我们通过索赔数据库澄清,孕妇降压药的处方在妊娠后半期增加,而抗癫痫药和抗焦虑药的处方在产后减少。对药剂师和药学专业学生的一项调查显示,他们缺乏关于有效摄入叶酸以降低婴儿神经管缺陷风险的认识。在参与铃木纪念医院宫内期婴儿及其父母纵向观察(BOSHI)研究、JECS以及东北医学综合研究机构出生与三代人(BirThree)队列研究的孕妇中,孕前补充叶酸的比例为6.3%-18.0%。通过仔细审查我院药物信息办公室的咨询记录以及应用我们的哺乳计划单的案例,发现日本药品说明书中的信息与《药物与母乳》等中的信息存在差异。所获得的结果已在日常临床实践中应用,我们正在采取措施继续开展研究。

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