Clin Infect Dis:接受治疗后,耐多药/耐利福平结核病孕妇的母婴结局

2020-04-09 MedSci原创 MedSci原创

由于孕妇及其婴儿常被排除在临床试验和扩大准入方案之外,关于其二线结核病药物的安全性和疗效的数据非常有限。

由于孕妇及其婴儿常被排除在临床试验和扩大准入方案之外,关于其二线结核病药物的安全性和疗效的数据非常有限。

 

研究纳入了2013年1月1日-2017年12月31日在南非KwaZulu-Natal的King Dinuzulu医院开始治疗多药/利福平耐药(MDR/RRR)-结核病的孕妇。进行了记录回顾以描述产妇治疗和妊娠结局,并进行临床评估来描述婴儿结局。

 

结果显示,在108名接受MDR/RRR-结核病治疗的孕妇中,88名(81%)为HIV感染者。72名(67%)妇女报告了MDR/RR-结核病治疗结果良好。109名婴儿中有99名(91%)为活产儿,但总的来说,52名(48%)妇女的妊娠结局不佳。58名(54%)妇女接受了苯达吉林,49名(45%)婴儿在子宫内接触过贝达奎林。与未接触过贝达奎林的婴儿相比,接触过贝达奎林的婴儿出生体重较低(45% vs 26%;P=0.034)。多变量分析结果显示,贝达奎林常与左氧氟沙星联合使用,都与低出生体重风险的增加独立相关。在12个月时接受评估的86名儿童中,72名(84%)结局良好;88%暴露于贝达奎林的婴儿发育正常,而未暴露于贝达奎林的婴儿则为82%。

 

综上所述,该研究结果表明,孕妇中的MDR/RR-结核病治疗结果与非妊娠期的成年人相当。虽然接触过贝达奎林的婴儿中,有更多的婴儿出生时体重较低,但80%以上的婴儿在一年后体重增加,发育正常。

 

原始出处:

 

Marian LovedayJennifer Hughes, et al., Maternal and infant outcomes among pregnant women treated for multidrug/rifampicin-resistant tuberculosis in South Africa. Clin Infect Dis. 2020 Mar 6:ciaa189. doi: 10.1093/cid/ciaa189.

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