孕妇服用抗组胺药不增加婴儿出生缺陷风险

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孕妇服用抗组胺药不增加婴儿出生缺陷风险。发表于The Journal of Allergy and Clinical Immunology: In Practice(JACI)的一篇文章认为,没有证据表明孕妇怀孕期间抗组胺药物和先天畸形之间存在联系。

抗组胺药主要用于治疗过敏,恶心和呕吐。一些抗组胺药需要医生处方,但大多数都可以是直接买到的非处方药。孕妇在怀孕期间经常使用处方或非处方抗组胺药。

波士顿大学的研究人员分析了1998-2010年的出生缺陷数据,在母亲分娩后6个月内进行了采访调查,包括各种处方药和非处方药的使用。

结果显示,13.7%的母亲使用了抗组胺药,最常用的药物是氯雷他定(3.1%),苯海拉明(4.2%),多西拉敏(1.9%),扑尔敏(1.7%)。没有发现任何一种药物和出生缺陷有关系。

尽管抗组胺药相对安全,文章还是建议怀孕妇女在需要服用这些药物之前应该先和医生咨询。

Assessment of Antihistamine Use in Early Pregnancy and Birth Defects

Background

Several studies have reported an association between use of specific antihistamines in early pregnancy and certain specific birth defects.

Objective

To test 16 previously hypothesized associations between specific antihistamines and specific birth defects, and to identify possible new associations.

Methods

We used 1998-2010 data from the Slone Epidemiology Center Birth Defects Study, a multicenter case-control surveillance program of birth defects in North America. Mothers were interviewed within 6 months of delivery about demographic, reproductive, medical, and behavioral factors, and details on the use of prescription and nonprescription medications. We compared first trimester exposure to specific antihistamines between 13,213 infants with specific malformations and 6982 nonmalformed controls by using conditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs), with adjustment for potential confounders, including indication for use.

Results

Overall, 13.7% of controls were exposed to antihistamines during the first trimester. The most commonly used medications were diphenhydramine (4.2%), loratadine (3.1%), doxylamine (1.9%), and chlorpheniramine (1.7%). When estimates were stable, none supported the previously hypothesized associations. Among more than 100 exploratory comparisons of other specific antihistamine-defect pairs, 14 had odds ratios ≥1.5, of which 6 had 95% CI bounds excluding 1.0 before but not after adjustment for multiple comparisons.

Conclusion

Our findings do not provide meaningful support for previously posited associations between antihistamines and major congenital anomalies; at the same time, we identified associations that had not been previously suggested. We suspect that previous associations may be chance findings in the context of multiple comparisons, a situation that may also apply to our new findings.

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