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先天性身体残疾女性在怀孕期间的用药情况。

Medication use during pregnancy among women with congenital physical disabilities.

机构信息

Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.

出版信息

Birth Defects Res. 2022 Aug 15;114(14):785-796. doi: 10.1002/bdr2.2048. Epub 2022 Jun 1.

Abstract

BACKGROUND

Medication use during pregnancy is common, with up to 90% of pregnant women taking at least one medication. Women with congenital physical disabilities often report co-occurring conditions during pregnancy that may warrant pharmaceutical treatment, however, research is limited. We aim to describe medication use during pregnancy including: pain, psychotropic, and antibacterial medication, among women with and without congenital physical disabilities.

METHODS

We used data from the Slone Birth Defects Study (1976-2015), a case-control study that collected information on pre-pregnancy health conditions and exposures among participating mothers. Women with congenital physical disabilities (n = 132) included women with spina bifida, cerebral palsy, muscular dystrophy, limb deficiencies, and other skeletal/connective tissue conditions and were matched by interview year and study site to women without congenital physical disabilities (n = 528). Proportions and difference in proportions for each medication were compared between groups. Simple proportions were also calculated for duration and multiple medication use variables.

RESULTS

Women with congenital physical disabilities more frequently reported use of pain (acetaminophen and opioids), psychotropic (antidepressants), and antibacterial medications during pregnancy. Women with congenital physical disabilities used pain and psychotropic medications for longer, frequent durations, and more frequently reported haven taken multiple medications during pregnancy.

CONCLUSION

Women with congenital physical disabilities report higher medication use during pregnancy compared to women without physical disabilities. Patterns may be attributable to co-occurring conditions or increased risk of pregnancy complications in this population. Further research is needed to describe the patterns of medication use for clinical decisions regarding treatment of pregnant women with disabilities.

摘要

背景

孕妇用药较为常见,高达 90%的孕妇至少服用一种药物。患有先天性身体残疾的女性在怀孕期间经常报告并发疾病,可能需要药物治疗,但相关研究有限。我们旨在描述孕妇用药情况,包括:有先天性身体残疾和无先天性身体残疾的女性在怀孕期间使用的止痛药、精神类药物和抗菌药物。

方法

我们使用了 Slone 出生缺陷研究(1976-2015 年)的数据,这是一项病例对照研究,收集了参与母亲的孕前健康状况和暴露情况的信息。患有先天性身体残疾的女性(n=132)包括患有脊柱裂、脑瘫、肌肉营养不良、肢体缺陷和其他骨骼/结缔组织疾病的女性,并按访谈年份和研究地点与无先天性身体残疾的女性(n=528)相匹配。比较了两组间每种药物的比例和比例差异。还计算了持续时间和多种药物使用变量的简单比例。

结果

患有先天性身体残疾的女性在怀孕期间更频繁地报告使用止痛药(对乙酰氨基酚和阿片类药物)、精神类药物(抗抑郁药)和抗菌药物。患有先天性身体残疾的女性使用止痛药和精神类药物的时间更长、更频繁,并且更频繁地报告在怀孕期间服用了多种药物。

结论

与无身体残疾的女性相比,患有先天性身体残疾的女性在怀孕期间报告的用药量更高。这种模式可能归因于并发疾病或该人群中妊娠并发症的风险增加。需要进一步研究来描述残疾孕妇治疗的药物使用模式,以做出临床决策。

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本文引用的文献

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Disabil Health J. 2022 Apr;15(2):101259. doi: 10.1016/j.dhjo.2021.101259. Epub 2021 Dec 1.
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MCN Am J Matern Child Nurs. 2019 Jul/Aug;44(4):196-205. doi: 10.1097/NMC.0000000000000537.
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Chronic pain during pregnancy: a review of the literature.孕期慢性疼痛:文献综述
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