A&R:怀孕期间服用羟氯喹的女性的分娩结果:一项前瞻性队列研究

2022-06-29 MedSci原创 MedSci原创

在这项研究中,没有证据表明在怀孕期间接受羟氯喹治疗的妇女发生结构性出生缺陷或其他不良后果的风险增加,婴儿出生时的头围除外。

   目的:先前小型研究的结果显示妊娠期间使用羟氯喹(HCQ)治疗的安全性良好。但最近的一项研究表明在怀孕期间接受≥400 mg/HCQ的妇女发生重大出生缺陷的频率增加。本研究旨在检查使用HCQ后女性的妊娠结局

   方法:研究队列包括前瞻性地参加了MotherToBaby/畸形学信息专家组织妊娠期自身免疫性疾病研究的孕妇,她们正在接受HCQ治疗。对照组是相同来源、随机选择的未接受HCQ治疗的患相同疾病的女性和健康女性,受试者匹配比例为11。通过访谈、医疗记录和畸形检查收集数据。妊娠结局指标包括是否存在重大和轻微出生缺陷、自然流产率、早产率和婴儿生长指标。

   结果:2004年至2018年间,837名孕妇符合研究纳入标准,其中包括279名怀孕期间接受HCQ治疗的妇女和279名未接受HCQ的对照组妇女。60名孕妇(7.2%)失访。在活产妇女中,232名在孕早期接触HCQ的妇女中有20名(8.6%)发生了作为妊娠结局的严重出生缺陷,而256名疾病匹配的未接受HCQ治疗的妇女中有19名(7.4%)(优势比 [ OR] 1.18, 95%置信区间[95% CI] 0.612.26) 239名健康对照中有13 (5.4%)(调整后的OR 0.76, 95% CI 0.282.05)。接受HCQ剂量≥400 mg/天的女性的风险没有差异。没有发现出生缺陷的模式。各组间自然流产或早产的发生率没有差异。与疾病匹配的未暴露对照组相比,HCQ暴露组的婴儿生长缺陷发生率没有差异,但婴儿出生时的头围除外(调整后的OR 1.8595% CI 1.07-3.20

   结论:在这项研究中,没有证据表明在怀孕期间接受HCQ治疗的妇女发生结构性出生缺陷或其他不良后果的风险增加,婴儿出生时的头围除外。对于接受HCQ治疗的孕妇,这些发现令人放心。

 

出处:Chambers, C.D., Johnson, D.L., Xu, R., Luo, Y., Felix, R., Fine, M., Lessard, C., Adam, M.P., Braddock, S.R., Robinson, L.K., Burke, L., Jones, K.L. and (2022), Birth Outcomes in Women Who Have Taken Hydroxycholoroquine During Pregnancy: A Prospective Cohort Study. Arthritis Rheumatol, 74: 711-724. https://doi.org/10.1002/art.42015

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    2022-04-28 linlin2312
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    2022-04-26 病毒猎手

    #羟氯喹#的安全性一直受到质疑,包括心脏毒性,不过这项研究倒令人放心一点了

    0

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    2022-04-26 yangchou

    好文章,谢谢分享。

    0

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