Department of Obstetrics and Gynaecology, Stavanger University Hospital, Stavanger, Norway
Department of Clinical Science, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway.
BMJ Open. 2022 Oct 7;12(10):e061837. doi: 10.1136/bmjopen-2022-061837.
We have previously found that allergy is a risk factor for early-onset pre-eclampsia. The aim of this study was to assess the association between pregestational maternal use of antihistamines and early-onset pre-eclampsia.
A population-based cohort study.
All women giving birth in Norway 2004-2016, including 692 487 pregnancies. Data from the Medical Birth Registry of Norway were linked with data from the Norwegian Prescription Database. Prescriptions of antihistamines were divided into three groups: before pregnancy (<6 months), early pregnancy (<20 weeks) and late pregnancy (20-36 weeks). ORs with 95% CIs for pre-eclampsia <34 and <37 weeks by antihistamine use were estimated by logistic regression and stratified on multiple pregnancy and parity. Predicted proportions (%) with 95% CIs were estimated.
Use of antihistamines in relation to pregnancy in allergic women.
Development of early-onset pre-eclampsia.
2997 (0.43%) and 5769 (0.83%) women had pre-eclampsia <34 and <37 weeks, respectively. Use of antihistamines before and in early pregnancy was associated with a risk of developing early-onset pre-eclampsia that was comparable to the background population (OR 1.0, 95% CI 0.8 to 1.2 and OR 0.9, 95% CI 0.7 to 1.1, respectively). Antihistamine use only in late pregnancy was not treated as exposure, but as an indicator of allergy, and was associated with an increased risk of early-onset pre-eclampsia (OR 1.8, 95% CI 1.5 to 2.2). Predicted proportions of pre-eclampsia <34 weeks were significantly lower in women using antihistamines before (0.41%, 95% CI 0.34 to 0.49) and in early pregnancy (0.37%, 95% CI 0.31 to 0.44), compared with women using antihistamines after placentation (0.69%, 95% CI 0.57 to 0.83). Results were similar for pre-eclampsia <37 weeks.
Antihistamine use before or during placentation was associated with reduced risk of developing early-onset pre-eclampsia in allergic women compared with women using antihistamines after placentation.
我们之前发现过敏是早发型子痫前期的一个危险因素。本研究旨在评估孕前母体使用抗组胺药与早发型子痫前期之间的关系。
基于人群的队列研究。
2004-2016 年在挪威分娩的所有妇女，包括 692487 例妊娠。挪威医学出生登记处的数据与挪威处方数据库的数据相关联。抗组胺药的处方分为三组：孕前（<6 个月）、孕早期（<20 周）和孕晚期（20-36 周）。通过逻辑回归和多胎妊娠和产次分层，估计了使用抗组胺药与子痫前期<34 周和<37 周的比值比（OR）及其 95%置信区间（CI）。使用 95%CI 估计了子痫前期<34 周和<37 周的预测比例（%）。
在过敏女性中，使用抗组胺药与妊娠的关系。
早发型子痫前期的发生。
分别有 2997（0.43%）和 5769（0.83%）名妇女发生了子痫前期<34 周和<37 周。孕前和孕早期使用抗组胺药与早发型子痫前期的发病风险相当（OR 1.0，95%CI 0.8 至 1.2 和 OR 0.9，95%CI 0.7 至 1.1）。仅在孕晚期使用抗组胺药不作为暴露因素，而是作为过敏的指标，与早发型子痫前期的风险增加相关（OR 1.8，95%CI 1.5 至 2.2）。与胎盘形成后使用抗组胺药的妇女相比，孕前（0.41%，95%CI 0.34%至 0.49%）和孕早期（0.37%，95%CI 0.31%至 0.44%）使用抗组胺药的妇女发生子痫前期<34 周的预测比例显著降低。对于子痫前期<37 周，结果相似。
与胎盘形成后使用抗组胺药的女性相比，过敏女性在胎盘形成前或形成时使用抗组胺药与早发型子痫前期的风险降低相关。
