Division of Maternal-Fetal Medicine and the Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, the Division of Pediatric Infectious Diseases and Global Health, Department of Pediatrics, and the Department of Bioengineering and Therapeutic Sciences, Institute for Human Genetics, University of California, San Francisco, San Francisco, California.
Obstet Gynecol. 2023 May 1;141(5):957-960. doi: 10.1097/AOG.0000000000005152. Epub 2023 Mar 15.
Nirmatrelvir-ritonavir (Paxlovid) is recommended to reduce the risk of hospitalization from coronavirus disease 2019 (COVID-19) in pregnancy. Data on use in pregnancy, including prescribing patterns and patient experience (adverse effects, incidence of rebound), are limited. We performed a cross-sectional study in which we surveyed a cohort of vaccinated pregnant or lactating individuals with breakthrough COVID-19. Of 35 pregnant respondents, 51.4% were prescribed and 34.3% took nirmatrelvir-ritonavir; of these, 91.7% experienced dysgeusia and 50.0% had rebound (50.0% positive test result, 33.3% return of symptoms). Three of five lactating respondents were prescribed and two took nirmatrelvir-ritonavir. There were no significant adverse outcomes. Unknown risk was the most common reason for declining nirmatrelvir-ritonavir. More research is needed to establish the safety of nirmatrelvir-ritonavir in pregnancy and lactation, to improve public health messaging, and to increase uptake of this treatment.
尼马曲韦-利托那韦（奈玛特韦/利托那韦片）被推荐用于降低妊娠女性感染 2019 冠状病毒病（COVID-19）的住院风险。关于该药在妊娠期间使用的数据，包括用药模式和患者体验（不良反应、反弹发生率）十分有限。我们开展了一项横断面研究，对患有 COVID-19 突破性感染的已接种疫苗的妊娠或哺乳期个体进行了调查。在 35 名妊娠应答者中，51.4%被处方了尼马曲韦-利托那韦，34.3%的人接受了该药治疗；其中，91.7%出现味觉障碍，50.0%出现反弹（50.0%检测结果阳性，33.3%症状复发）。5 名哺乳期应答者中有 3 人被处方了尼马曲韦-利托那韦，其中 2 人接受了该药治疗。未出现显著不良结局。拒绝使用尼马曲韦-利托那韦的最常见原因是未知风险。需要进一步研究以确定尼马曲韦-利托那韦在妊娠和哺乳期的安全性，改善公共卫生信息传递，并提高这种治疗方法的使用率。
