Effect of mebendazole therapy during pregnancy on birth outcome
Effect of mebendazole therapy during pregnancy on birth outcome
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DOI：
10.1016/s0140-6736(98)06308-9
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发表时间：
1999-04-03
期刊：
影响因子：
168.9
通讯作者：
de Silva, HJ
中科院分区：
文献类型：
--
作者：
de Silva, NR;Sirisena, JLGJ;de Silva, HJ
背景在钩虫流行地区，产前常规甲苯咪唑治疗可大大降低妊娠期贫血的患病率。然而，目前这并不是一个被广泛接受的控制策略，因为缺乏关于该药物安全性的数据。方法在斯里兰卡进行一项横断面研究，推荐孕中期妇女服用甲苯咪唑。这项研究选择了两家医院，并招募了1996年5月至1997年3月在那里分娩的妇女。我们比较了孕期服用甲苯咪唑的母亲和没有服用驱虫药的母亲(对照组)的重大先天性缺陷、死产、围产儿死亡和低出生体重(小于或等于1500 g)的发生率。结果发现，甲苯咪唑组的重大先天性缺陷的发生率并不显著高于对照组(97例[1.8%]比26例[1.5%]1737例；优势比1.24[95%可信区间0.8-1.91]，p=0.39)。在407名在妊娠早期服用甲苯咪唑的妇女(与医生的建议相反)中，10名(2.5%)患有严重的先天性缺陷(优势比为1.66[0.81-3.56]，p=0.23)。甲苯咪唑组死产和围产儿死亡比例显著低于对照组(1.9vs3.3%，0.55[95%可信区间0.4~0.77])，低出生体重儿比例显著低于对照组(1.1vs 2.3%，0.47[95%CI 0.32~0.71])。这种疗法可以为发展中国家的孕妇提供有益的效果，因为那里的肠道蠕虫硫酶是地方病。
Background In areas endemic for hookworm, routine antenatal mebendazole therapy could greatly reduce the prevalence of anaemia in pregnancy. At present, however, this is not a widely accepted control strategy because of a lack of data on the safety of the drug. We assessed the effect of mebendazole therapy during pregnancy on birth outcome.Methods A cross-sectional study was done in Sri Lanka, where prescription of mebendazole to women in the second trimester of pregnancy is recommended. Two hospitals were chosen for the study, and women who gave birth there between May, 1996, and March, 1997, were recruited. We compared the rates of major congenital defects, stillbirth, perinatal death, and low birthweight (less than or equal to 1500 g) among babies of mothers who had taken mebendazole during pregnancy with those whose mothers had not taken an anthelmintic (controls).Findings The rate of major congenital defects was not significantly higher in the mebendazole group than in the control group (97 [1.8%] of 5275 vs 26 [1.5%] of 1737; odds ratio 1.24 [95% CI 0.8-1.91], p=0.39). Among 407 women who had taken mebendazole in the first trimester (contrary to medical advice), 10 (2.5%) had major congenital defects (odds ratio vs controls 1.66 [0.81-3.56], p=0.23). The proportions of stillbirths and perinatal deaths were significantly lower in the mebendazole group (1.9 vs 3.3%, 0.55 [95% CI 0.4-0.77]), as was the proportion of low-birthweight babies (1.1 vs 2.3%, 0.47 [95% CI 0.32-0.71]).Interpretation Mebendazole therapy during pregnancy is not associated with a significant increase in major congenital defects, but our results indicate that it should be avoided during the first trimester. This therapy could offer beneficial effects to pregnant women in developing countries, where intestinal helminthiases are endemic.