Centre de Pharmacovigilance Et de Pharmacoépidémiologie, Service de Pharmacologie Médicale, CHU de Lille, Lille, France.
Service d'explorations Fonctionnelles Cardiovasculaires, Institut Cœur Poumon, CHU Lille, Lille, France.
Eur J Clin Pharmacol. 2024 Dec;80(12):1937-1943. doi: 10.1007/s00228-024-03753-y. Epub 2024 Sep 11.
At Lille University Hospital, a pregnancy heart team including cardiologists, obstetricians, pediatricians, anesthetists, geneticists, and pharmacologists discusses about treatment compatibility taken during breastfeeding in pregnant women (or those wishing to be pregnant) with complex cardiovascular pathologies. Beta-blockers are among the drug most often used in these patients, and data are missing or suggest a risk to the breastfed child. The aim of this study was to evaluate the proportion of women treated with beta-blockers, identified during the multidisciplinary meeting, who breastfed and to monitor adverse effects (AEs) in newborns.
A prospective descriptive study was conducted from 1 December 2017 to 1 December 2021. All pregnant patients followed up by the pregnancy heart team in Lille University Hospital, treated with beta-blockers and who gave birth, were contacted as part of the pharmacovigilance follow-up.
The proportion of women treated with beta-blockers intending to breastfeed was 69.8%. Among the 53 women interviewed, 49% did not breastfeed, including 10 because of the theoretical incompatibility of their beta-blocker with breastfeeding. Among the 27 women who breastfed, 30% breastfed while treated with a theoretically incompatible beta-blocker; 56% was changed from their initial beta-blocker to allow safe breastfeeding. No serious AE was observed.
To our knowledge, our study is the largest series of patients treated with beta-blockers during breastfeeding. Taking a treatment can be an obstacle to breastfeeding, but for the particular case of beta-blockers, even if the available data are few and sometimes worrying, the data from this study are reassuring.
在里尔大学医院，一个由心脏病专家、妇产科医生、儿科医生、麻醉师、遗传学家和药理学家组成的妊娠心脏团队讨论了在患有复杂心血管疾病的孕妇（或希望怀孕的孕妇）哺乳期期间使用的治疗药物的兼容性。β受体阻滞剂是这些患者中最常使用的药物之一，但数据缺失或提示对母乳喂养的婴儿有风险。本研究旨在评估在多学科会议中确定的接受β受体阻滞剂治疗的女性中母乳喂养的比例，并监测新生儿的不良反应（AE）。
这是一项从 2017 年 12 月 1 日至 2021 年 12 月 1 日进行的前瞻性描述性研究。在里尔大学医院接受妊娠心脏团队随访并接受β受体阻滞剂治疗且分娩的所有孕妇都作为药物警戒随访的一部分进行了联系。
打算母乳喂养的β受体阻滞剂治疗女性比例为 69.8%。在接受采访的 53 名女性中，49%没有母乳喂养，其中 10 名女性是因为其β受体阻滞剂与母乳喂养理论上不兼容。在 27 名母乳喂养的女性中，30%在接受理论上不兼容的β受体阻滞剂治疗时母乳喂养；56%的人从最初的β受体阻滞剂更换为允许安全母乳喂养的药物。未观察到严重的 AE。
据我们所知，我们的研究是接受β受体阻滞剂母乳喂养的最大系列患者之一。接受治疗可能是母乳喂养的障碍，但对于β受体阻滞剂的特殊情况，尽管可用数据很少且有时令人担忧，但本研究的数据令人安心。
