Larivaara P, Hartikainen A L, Rantakallio P
Department of Public Health Science and General Practice, University of Oulu, Finland.
J Clin Epidemiol. 1996 Nov;49(11):1309-13. doi: 10.1016/s0895-4356(96)00203-x.
This study reports the use of psychotropic drugs and pregnancy outcome in a prospective survey carried out in northern Finland in 1985-1986, consisting of 7933 pregnant women and their 8030 births. Of the mothers, 120 (1.5%) used psychotropic drugs during pregnancy and of them 26 (0.3% of the total) used these drugs before and during the pregnancy. According to the logistic regression analysis, the biological and social background variables associating significantly with the use of these drugs were maternal advanced age and multiparity (> 35 years and > 4 parous), overweight (body mass index > the 90th percentile), smoking, alcohol use, belonging to social class IV, and failure to ensure contraception. The users needed hospital observation significantly more often during pregnancy (regular users, 80.8%; occasional users, 38.3; nonusers, 27.4%) and the adjustment of the background variables did not change this result. Of the pregnancy complications bleeding was significantly more common among users than nonusers (23.3 vs. 13.2%) and this difference was not explained by difference in background variables. The mean birth weight of infants of the regular users was significantly lower (255 g) when background variables were standardized by linear regression analysis. No association of increased number of birth defects was found with usage of psychotropic drugs.
本研究报告了1985 - 1986年在芬兰北部进行的一项前瞻性调查中精神药物的使用情况及妊娠结局，该调查涵盖7933名孕妇及其8030次分娩。在这些母亲中，120名（1.5%）在孕期使用了精神药物，其中26名（占总数的0.3%）在孕前及孕期均使用了这些药物。根据逻辑回归分析，与使用这些药物显著相关的生物学和社会背景变量包括母亲高龄和多产（>35岁且生育次数>4次）、超重（体重指数>第90百分位数）、吸烟、饮酒、属于社会阶层IV以及未采取避孕措施。使用者在孕期需要住院观察的频率显著更高（经常使用者为80.8%；偶尔使用者为38.3%；未使用者为27.4%），且对背景变量进行调整后这一结果未改变。在妊娠并发症中，使用者出现出血的情况显著多于未使用者（23.3%对13.2%），且背景变量的差异无法解释这一差异。通过线性回归分析对背景变量进行标准化后，经常使用者所生婴儿的平均出生体重显著更低（低255克）。未发现精神药物使用与出生缺陷数量增加之间存在关联。
