Stenius-Aarniala B, Riikonen S, Teramo K
Department of Pulmonary Medicine, University Central Hospital, Helsinki, Finland.
Chest. 1995 Mar;107(3):642-7. doi: 10.1378/chest.107.3.642.
Oral theophylline treatment may be helpful in controlling severe asthma during pregnancy. This treatment, however, has been suspected of causing both complications and malformations. The objective of this investigation was to study the influence of theophylline treatment on the course of pregnancy and delivery and on maternal and infant health.
Respiratory unit, antenatal outpatient departments, and labor and delivery rooms.
Case-control study.
The data of 212 pregnant asthmatics with theophylline treatment (AT) were compared with findings in 292 pregnant asthmatics without theophylline (A) and 237 nonasthmatic pregnant control subjects (C).
There were no significant differences among groups as to age, height, age of onset of asthma, lung function, parity, or smoking. In the AT group, 19% were treated for acute exacerbations of the asthma as compared with 6% in the A group (p < 0.001). The incidence of preeclampsia was higher in the AT (15.6%) than in the C (6.4%) group (p < 0.03). Theophylline treatment at term was not associated with premature contractions or premature rupture of membranes, hemorrhage, placenta previa, abruption of the placenta, abnormal fetus position, frequent induction or augmentation of labor, prolonged third phase of delivery, or increased hemorrhage post partum. No differences among groups were seen with regard to gestational age, birth weight, Apgar scores, or perinatal deaths. Jaundice in the newborn, necessitating treatment with blue light, was more common in the AT (15.0%) than in the C group (7.8%) (p < 0.05). Three infants of 121 patients treated with theophylline during the first trimester were born with malformations; in the 91 patients treated with theophylline only during the second and third trimester, and the asthmatic control group, the corresponding figures were 4 and 3.
During the second and third trimesters until term, theophylline treatment using moderate doses can be considered safe. The safety of theophylline treatment during the first trimester with regard to teratogenicity remains to be determined.
口服茶碱治疗可能有助于控制孕期严重哮喘。然而，这种治疗方法被怀疑会引发并发症和畸形。本研究的目的是探讨茶碱治疗对妊娠过程、分娩以及母婴健康的影响。
呼吸科、产前门诊、产房。
病例对照研究。
将212例接受茶碱治疗（AT）的妊娠哮喘患者的数据与292例未接受茶碱治疗（A）的妊娠哮喘患者以及237例非哮喘妊娠对照者（C）的结果进行比较。
各组在年龄、身高、哮喘发病年龄、肺功能、产次或吸烟方面无显著差异。AT组中19%的患者因哮喘急性加重接受治疗，而A组为6%（p < 0.001）。子痫前期的发生率在AT组（15.6%）高于C组（6.4%）（p < 0.03）。足月时使用茶碱治疗与早产宫缩、胎膜早破、出血、前置胎盘、胎盘早剥、胎位异常、频繁引产或加强宫缩、第三产程延长或产后出血增加无关。各组在孕周、出生体重、阿氏评分或围产期死亡方面无差异。新生儿黄疸需蓝光治疗在AT组（15.0%）比C组（7.8%）更常见（p < 0.05）。121例在孕早期接受茶碱治疗的患者中有3例婴儿出生时有畸形；在仅在孕中期和晚期接受茶碱治疗的91例患者以及哮喘对照组中，相应数字分别为4例和3例。
在孕中期和晚期直至足月，使用中等剂量的茶碱治疗可被认为是安全的。孕早期茶碱治疗在致畸性方面的安全性仍有待确定。
