Prevalence of polypharmacy in pregnancy: a systematic review.
Prevalence of polypharmacy in pregnancy: a systematic review.
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DOI：
10.1136/bmjopen-2022-067585
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发表时间：
2023-03-06
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
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在过去的几十年里，孕妇使用药物的情况一直在上升，但关于多种药物的报道是零星的。本综述的目的是找出报道孕妇中多种药物的患病率、妊娠期间服用多种药物的妇女的多病患病率以及对孕产妇和后代结局的相关影响的文献。MEDLINE和Embase从建立到2021年9月14日进行了检索，纳入了关于妊娠期多种用药流行率或多种药物使用的介入性试验、观察性研究和系统评价。提取了多种药物的患病率、多种疾病的患病率、药物组合以及妊娠和后代结局的数据。进行描述性分析。14项研究符合审查标准。妇女在怀孕期间服用两种或两种以上药物的患病率从4.9%（4.3%-5.5%）到62.4%（61.3%-63.5%）不等，中位数为22.5%。在妊娠早期，患病率为4.9%（4.7%-5.14%）至33.7%（32.2%-35.1%）。没有研究报道多重发病的患病率，或暴露于多种药物的妇女的相关妊娠结局。孕妇的多重用药负担很大。有必要提供有关孕期联合用药的证据，这对患有多种长期疾病的妇女有何具体影响，以及相关的益处和危害。我们的系统综述显示，妊娠期间服用多种药物的负担很大，但对妇女和后代的影响尚不清楚。CRD42021223966。
The use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes. MEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included. Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed. Fourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy. There is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms. Our systematic review shows significant burden of polypharmacy in pregnancy but outcomes for women and offspring are unknown. CRD42021223966.
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作者：
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