■怀孕期间经常接触药物,在怀孕的头三个月甚至更多,因为孕妇可能不知道自己的病情。我们使用可用的电子健康记录(EHR)来描述孕妇在妊娠早期使用药物的情况,并比较流产(选择性或自发性)的妇女与活产的妇女之间的药物暴露情况。
■堕胎的病例对照研究,选择性或自发性(病例),从2012年到2020年,在加泰罗尼亚初级卫生电子健康记录(加泰罗尼亚初级卫生电子健康记录)中,每一个国家的信息和活产妊娠(对照)。在怀孕的头三个月期间暴露于药物被认为是通过条件逻辑回归来估计与流产的关联,并根据健康状况和其他药物暴露进行调整。
■六万三百五十次流产与118,085次活产妊娠发作相匹配。病例的酒精摄入量较高(9.9%vs.7.2%,p<0.001),吸烟(4.5%与3.6%,p<0.001),和以前的堕胎(9.9%与7.8%,p<0.001)。焦虑(30.3%和25.1%,p<0.001),呼吸系统疾病(10.6%和9.2%,p<0.001),和偏头痛(8.2%和7.3%,p<0.001),对于案例和控制,分别,是最常见的基线条件。病例的药物暴露率较低,40,148(66.5%)与80,449(68.1%),p<0.001。发现全身性抗组胺药与流产有关(调整后的比值比[ORadj]1.23,95%置信区间[CI]1.19-1.27),抗抑郁药(ORadj1.11,95%CI1.06-1.17),抗焦虑药(ORadj1.31,95%CI1.26-1.73),和非甾体抗炎药(ORadj1。63,95%CI1.59-1.67)。
这些在怀孕的头三个月期间的高药物暴露率突出了知情处方对有生育潜力的妇女的相关性。
UNASSIGNED: Drug exposure during pregnancy is frequent, even more during first trimester as pregnant women might not be aware of their condition. We used available electronic health records (EHRs) to describe the use of medications during the first trimester in pregnant women and to compare drug exposure between those women who had an abortion (either elective or spontaneous) compared to those who had live births.
UNASSIGNED: Case-control study of abortions, either elective or spontaneous (cases), and live birth pregnancies (controls) in Sistema d\'Informació per al Desenvolupament de la Investigació en Atenció Primària (Catalan Primary Health electronic health records) from 2012 to 2020. Exposure to drugs during first trimester of pregnancy was considered to estimate the association with abortion by conditional logistic regression and adjusted by health conditions and other drugs exposure.
UNASSIGNED: Sixty thousand three hundred fifty episodes of abortions were matched to 118,085 live birth pregnancy episodes. Cases had higher rates of alcohol intake (9.9% vs. 7.2%, p < 0.001), smoking (4.5% vs. 3.6%, p < 0.001), and previous abortions (9.9% vs. 7.8%, p < 0.001). Anxiety (30.3% and 25.1%, p < 0.001), respiratory diseases (10.6% and 9.2%, p < 0.001), and migraine (8.2% and 7.3%, p < 0.001), for cases and controls, respectively, were the most frequent baseline conditions. Cases had lower rate of drug exposure, 40,148 (66.5%) versus 80,449 (68.1%), p < 0.001. Association with abortion was found for systemic antihistamines (adjusted odds ratio [ORadj] 1.23, 95% confidence interval [CI] 1.19-1.27), antidepressants (ORadj 1.11, 95% CI 1.06-1.17), anxiolytics (ORadj 1.31, 95% CI 1.26-1.73), and nonsteroidal anti-inflammatory drugs (ORadj 1. 63, 95% CI 1.59-1.67).
UNASSIGNED: These high rates of drug exposures during the first trimester of pregnancy highlights the relevance of informed prescription to women with childbearing potential.