局部前列腺素类似物应用与自然流产风险的相关性。
Association of Topical Prostaglandin Analogue Use With Risk of Spontaneous Abortion.
机构信息
Collaboration for Epidemiology of Ocular Diseases (CEPOD), Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada.
出版信息
JAMA Ophthalmol. 2022 Jun 1;140(6):634-636. doi: 10.1001/jamaophthalmol.2022.0628.
IMPORTANCE
Recent case reports suggest use of topical prostaglandin analogues (PGAs) might increase the risk of spontaneous abortions in pregnant people who take these drugs for intraocular pressure control. However, because these reports are derived mainly from voluntary adverse drug reaction databases, they might be prone to reporting bias.
OBJECTIVE
To examine the risk of spontaneous abortions among pregnant people who take topical PGAs.
DESIGN, SETTING, AND PARTICIPANTS: The PharMetrics Plus database (IQVIA) for health claims in the United States from 2006 to 2020 was used as the data source. The percentage of spontaneous abortions was quantified among patients aged 15 to 45 years who were pregnant and took a topical PGA medication during this period compared with a random sample of people in the database not taking a PGA agent.
MAIN OUTCOMES AND MEASURES
Diagnosis of a spontaneous abortion was ascertained through procedure codes or codes from the International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision.
RESULTS
A total of 3881 people of reproductive age who were prescribed PGAs and 3881 control participants not taking PGAs were identified. Among the 3881 patients in the PGA cohort, 261 were pregnant and 26 had a spontaneous abortion code. Among the 26 individuals, 12 (4.6%) had a spontaneous abortion code within 90 days of the pregnancy code and had an overlapping prescription for a PGA. Among the 12 individuals, 5 (41.7%) were in the age category 40 to 45 years. In the control group, there were 801 pregnancies, 56 of which led to spontaneous abortions (7%), resulting in an increased risk of 2.4% (95% CI, -0.7% to 5.4%; P = .17).
CONCLUSION AND RELEVANCE
The results of this case-series study suggest no association between use of PGAs and risk of spontaneous abortions. Given the nature of this study design and potential for unmeasured confounding factors, these results could be explored further in future epidemiologic studies that can better control for potential confounding variables and more accurately ascertain spontaneous abortions through perinatal databases.
重要性
最近的病例报告表明，在因眼压控制而使用这些药物的孕妇中，局部前列腺素类似物 (PGA) 的使用可能会增加自然流产的风险。然而，由于这些报告主要来自于自愿药物不良反应数据库，因此可能容易受到报告偏倚的影响。
目的
检查使用局部 PGAs 的孕妇自然流产的风险。
设计、设置和参与者：本研究使用美国 PharMetrics Plus 数据库（IQVIA）中 2006 年至 2020 年的健康索赔数据作为数据源。与数据库中未使用 PGA 药物的随机样本相比，比较了在此期间接受局部 PGA 药物治疗的 15 至 45 岁孕妇中自然流产的比例。
主要结局和测量指标
通过程序代码或疾病分类代码，第九版国际疾病分类和国际疾病分类、第十版相关健康问题分类系统，确定自然流产的诊断。
结果
共确定了 3881 名接受 PGA 治疗的育龄妇女和 3881 名未接受 PGA 治疗的对照参与者。在 PGA 队列的 3881 名患者中，有 261 名孕妇，26 名发生自然流产。在这 26 人中，有 12 人（4.6%）在妊娠代码后 90 天内有自然流产代码，并重叠开具了 PGA 处方。在这 12 人中，有 5 人（41.7%）年龄在 40 至 45 岁之间。在对照组中，有 801 例妊娠，其中 56 例导致自然流产（7%），风险增加 2.4%（95%CI，-0.7%至 5.4%；P=0.17）。
结论和相关性
这项病例系列研究的结果表明，PGA 的使用与自然流产的风险之间没有关联。鉴于本研究设计的性质以及潜在的无法测量的混杂因素，这些结果可以在未来的流行病学研究中进一步探讨，这些研究可以更好地控制潜在的混杂变量，并通过围产期数据库更准确地确定自然流产。
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