Undela Krishna, Gurumurthy Parthasarathi, Sujatha M S
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research Guwahati, Kamrup, Assam.
Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
Perspect Clin Res. 2023 Jan-Mar;14(1):10-15. doi: 10.4103/picr.picr_16_21. Epub 2021 Oct 23.
In view of the raising rate of adverse birth outcomes (ABOs) across the globe, this study was conducted to assess the impact of medical conditions and medications received during pregnancy on ABOs.
A prospective case-control study was conducted at the Department of Obstetrics and Gynecology of a tertiary care hospital over a period of 3 years from July 2015 to June 2018. Liveborn and stillborn neonates included in the study were categorized into cases and controls based on the presence or absence of composite ABOs, respectively. Binary logistic regression analysis was used to identify the risk factors for ABOs among medical conditions and medications received by mothers during their current pregnancy.
Among 1214 neonates included in the study, 556 (45.8%) were identified with composite ABOs, the majority were low birth weight (320 [26.4%]) and preterm birth 300 (24.7%). After adjusting for confounding factors, it was identified that hypertension (adjusted odds ratio [aOR] 7.3), oligohydramnios (aOR 3.9), anemia (aOR 3.2), nifedipine (aOR 10.0), nicardipine (aOR 5.3), and magnesium sulfate (aOR 5.3) were the risk factors for overall and specific ABOs like preterm birth and low birth weight. It was also identified that the early detection and management of hypertension with antihypertensives like labetalol and methyldopa can reduce the risk of preterm birth by 93% and 88%, respectively.
Medical conditions such as hypertension, oligohydramnios, and anemia and medications such as nifedipine, nicardipine, and magnesium sulfate during pregnancy were identified as the risk factors for overall and specific ABOs like preterm birth and low birth weight.
鉴于全球不良出生结局（ABO）发生率不断上升，本研究旨在评估孕期的医疗状况和所服用药物对ABO的影响。
2015年7月至2018年6月期间，在一家三级护理医院的妇产科进行了一项前瞻性病例对照研究。纳入研究的活产和死产新生儿分别根据是否存在复合ABO分为病例组和对照组。采用二元逻辑回归分析来确定母亲在本次孕期所患医疗状况和所服用药物中ABO的危险因素。
在纳入研究的1214例新生儿中，556例（45.8%）被确定为复合ABO，其中大多数为低出生体重（320例[26.4%]）和早产300例（24.7%）。在调整混杂因素后，确定高血压（调整优势比[aOR] 7.3）、羊水过少（aOR 3.9）、贫血（aOR 3.2）、硝苯地平（aOR 10.0）、尼卡地平（aOR 5.3）和硫酸镁（aOR 5.3）是总体和特定ABO（如早产和低出生体重）的危险因素。还发现，使用拉贝洛尔和甲基多巴等抗高血压药物对高血压进行早期检测和管理，可分别将早产风险降低93%和88%。
孕期的高血压、羊水过少和贫血等医疗状况以及硝苯地平、尼卡地平、硫酸镁等药物被确定为总体和特定ABO（如早产和低出生体重）的危险因素。
