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2011年至2020年孕期头三个月喹诺酮类药物的使用与子代患特应性皮炎、哮喘和过敏的风险

Quinolone Use during the First Trimester of Pregnancy and the Risk of Atopic Dermatitis, Asthma, and Allergies of Offspring during 2011 to 2020.

作者信息

Chae Jungmi, Choi Yeon-Mi, Kim Yong Chan, Kim Dong-Sook

机构信息

Department of Research, Health Insurance Review and Assessment Service, Wonju, Korea.

National Emergency Medical Center, National Medical Center, Seoul, Korea.

出版信息

Infect Chemother. 2024 Dec;56(4):461-472. doi: 10.3947/ic.2024.0030. Epub 2024 Sep 11.

Abstract

BACKGROUND

Many pregnant women receive antibiotic treatment for infections. We investigated the association between quinolone use in the first trimester of pregnancy and the risk of adverse health outcomes for the child in Korea.

MATERIALS AND METHODS

This nationwide, population-based cohort study used data on mother-child pairs from the National Health Insurance claims database. This study cohort included 2,177,765 pregnancies from January 1, 2011, to December 31, 2020, and 87,456 women were prescribed quinolones during pregnancy. After propensity score matching, the final number of study subjects was 84,365 for both quinolone and non-antibiotic users. We examined the subjects' exposure to quinolone antibiotics. The main outcome measures were absolute and relative risks of atopic dermatitis, asthma, and allergies. We adjusted for potential confounders.

RESULTS

Quinolones were prescribed at least once during the first trimester in 4.01% of pregnancies. Quinolone users had significantly higher absolute risks than non-antibiotic users for atopic dermatitis, asthma, and allergies, with significantly elevated risk ratios (RRs) for these conditions (atopic dermatitis: RR, 1.09; 95% confidence interval [CI], 1.08-1.11, asthma: RR, 1.04; 95% CI, 1.03-1.05, and allergies: RR, 1.10; 95% CI, 1.08-1.13).

CONCLUSION

We found that quinolone exposure during the first trimester of pregnancy increased the risk of atopic dermatitis, asthma, and allergies. This study could provide physicians with useful information when selecting antibiotics for pregnant women.

摘要

背景

许多孕妇因感染接受抗生素治疗。我们调查了韩国孕期头三个月使用喹诺酮类药物与儿童不良健康结局风险之间的关联。

材料与方法

这项基于全国人群的队列研究使用了国民健康保险索赔数据库中母婴对的数据。该研究队列包括2011年1月1日至2020年12月31日期间的2,177,765例妊娠,87,456名女性在孕期被开具了喹诺酮类药物。在倾向得分匹配后,喹诺酮类药物使用者和非抗生素使用者的最终研究对象数量均为84,365人。我们检查了研究对象对喹诺酮类抗生素的暴露情况。主要结局指标是特应性皮炎、哮喘和过敏的绝对风险和相对风险。我们对潜在混杂因素进行了调整。

结果

4.01%的妊娠在孕期头三个月至少开具过一次喹诺酮类药物。喹诺酮类药物使用者患特应性皮炎、哮喘和过敏的绝对风险显著高于非抗生素使用者,这些疾病的风险比(RRs)显著升高(特应性皮炎:RR,1.09;95%置信区间[CI]为1.08 - 1.11,哮喘:RR,1.04;95% CI为1.03 - 1.05,过敏:RR,1.10;95% CI为1.08 - 1.13)。

结论

我们发现孕期头三个月接触喹诺酮类药物会增加患特应性皮炎、哮喘和过敏的风险。这项研究可为医生在为孕妇选择抗生素时提供有用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d380/11704861/f2ce6de59126/ic-56-461-g001.jpg

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