Relative perinatal safety of salmeterol vs formoterol and fluticasone vs budesonide use during pregnancy
Relative perinatal safety of salmeterol vs formoterol and fluticasone vs budesonide use during pregnancy
复制标题
DOI：
10.1016/j.anai.2014.02.010
复制
发表时间：
2014-05-01
影响因子：
5.9
通讯作者：
Blais, Lucie
中科院分区：
文献类型：
--
作者：
Cossette, Benoit;Beauchesne, Marie-France;Blais, Lucie
背景资料：最近的哮喘指南认可长效β 2受体激动剂（LABAs）和轻、中等剂量吸入性皮质类固醇（ICS）在妊娠期控制哮喘时的安全性，但没有说明每类药物的首选药物。目的：评估妊娠期使用沙美特罗和福莫特罗（LABAs）以及氟替卡松和布地奈德（ICS）的相对围产期安全性。从加拿大魁北克的卫生保健管理数据库中选择一个哮喘妇女的妊娠子队列。低出生体重（LBW）定义为体重低于2,500 g，早产（PB）定义为妊娠37周前分娩，小于胎龄儿（SGA）定义为出生体重低于第10百分位数。治疗与沙美特罗与福莫特罗和氟替卡松与布地奈德对结果的影响与广义估计方程models.Results：LABA和ICS亚组分别由547（385沙美特罗和162福莫特罗用户）和3,798（3,190氟替卡松和608布地奈德用户）怀孕，分别。未观察到LBW的统计学显著差异（比值比[OR]，0.91; 95%置信区间[CI]，0.44-1.88），PB（OR，1.11; 95% CI，0.56-2.23）和SGA（OR，1.16; 95% CI，0.67-2.02）暴露于沙美特罗与福莫特罗或暴露于氟替卡松与布地奈德的女性之间的新生儿（LBW：OR，1.08; 95%CI，0.76-1.52; PB：OR，1.07; 95%CI，0.78-1.49; SGA：OR：1.10; 95%CI，0.85-1.44）结论：本研究未提供LABA或ICS中的一种的围产期安全性高于另一种的证据。(C)2014年美国过敏，哮喘和免疫学学院。爱思唯尔公司出版All rights reserved.
Background: Recent asthma guidelines endorse the safety of long-acting beta(2)-agonists (LABAs) and of mild and moderate doses of inhaled corticosteroids (ICSs) when required to control asthma during pregnancy, yet do not state a preferred medication within each class.Objective: To estimate the relative perinatal safety with the use of salmeterol and formoterol (LABAs) and that of fluticasone and budesonide (ICSs) during pregnancy.Methods: A subcohort of pregnancies from asthmatic women was selected from health care administrative databases of Quebec, Canada. Low birth weight (LBW) was defined as weight less than 2,500 g, preterm birth (PB) as delivery before 37 weeks of gestation, and small for gestational age (SGA) as a birth weight below the 10th percentile. The effect of treatment with salmeterol vs formoterol and fluticasone vs budesonide on the outcomes was determined with generalized estimating equation models.Results: The LABA and ICS subcohorts were composed of 547 (385 salmeterol and 162 formoterol users) and 3,798 (3,190 fluticasone and 608 budesonide users) pregnancies, respectively. No statistically significant differences were observed for LBW (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.44-1.88), PB (OR, 1.11; 95% CI, 0.56-2.23), and SGA (OR, 1.16; 95% CI, 0.67-2.02) newborns between women exposed to salmeterol vs formoterol or between women exposed to fluticasone vs budesonide (LBW: OR, 1.08; 95% CI, 0.76-1.52; PB: OR, 1.07; 95% CI, 0.78-1.49; and SGA, OR: 1.10; 95% CI, 0.85-1.44).Conclusion: This study does not provide evidence of greater perinatal safety for one LABA or one ICS over the other. (C) 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.