Intraocular pressure-lowering medications during pregnancy and risk of neonatal adverse outcomes: a propensity score analysis using a large database
Intraocular pressure-lowering medications during pregnancy and risk of neonatal adverse outcomes: a propensity score analysis using a large database
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DOI：
10.1136/bjophthalmol-2020-316198
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发表时间：
2021-10-01
影响因子：
4.1
通讯作者：
Aihara, Makoto
中科院分区：
文献类型：
--
作者：
Hashimoto, Yohei;Michihata, Nobuaki;Aihara, Makoto
背景/目的：研究妊娠期暴露于降眼压药物与新生儿不良结局之间的关系。这项回顾性队列研究使用了2005-2018年JMDC索赔数据库（JMDC，日本东京）。我们提取了青光眼孕妇的数据，包括在妊娠早期（1）任何降IOP药物的分配，（2）仅前列腺素类似物（PG）和3）仅β受体阻滞剂。我们比较了有和没有降眼压药物的妇女之间先天性异常（CA）、早产（PB）、低出生体重（LBW）的频率以及这三项指标的综合结果。我们使用逻辑回归计算倾向评分（PS），其中降低IOP药物的使用针对已知混杂因素（妊娠期间疾病和其他慢性合并症）进行回归。然后我们进行逻辑回归，其中新生儿不良结局与使用降低IOP的药物进行回归，并对PS进行调整。结果我们确定了826名符合条件的妇女，其中91人（11%）接受了任何降眼压药物。在使用和未使用降眼压药物的母亲中，CA发生率分别为9.9%和6.4%，PB发生率分别为2.2%和4.5%，LBW发生率分别为9.9%和6.0%，复合结局分别为17.6%和13.3%。调整PS后，降低IOP的药物与更频繁的CA没有显着相关性（校正OR（aOR），1.43; 95% CI，0.66 - 3.12），PB（aOR，0.45; 95% CI，0.10 - 1.97）、LBW（aOR，2.11; 95% CI，0.98 - 4.57）或复合结局（aOR，1.40; 95% CI，0.78 - 2.53）。仅PG和仅β受体阻滞剂的结果相似。结论：在妊娠早期使用降眼压药物与CA、PB或LBW的增加无显著相关性。
Background/Aims To investigate the association between exposure to intraocular pressure (IOP)-lowering medications during pregnancy and neonatal adverse outcomes. Methods This retrospective, cohort study used the JMDC Claims Database (JMDC, Tokyo, Japan), 2005-2018. We extracted data on pregnant women with glaucoma, including dispensation of (1) any IOP-lowering medications, (2) only prostaglandin analogues (PGs) and 3) only beta-blockers, during the first trimester. We compared frequency of congenital anomalies (CA), preterm birth (PB), low birth weight (LBW) and the composite outcome of these three measures, between the women with and without IOP-lowering medications. We calculated propensity scores (PSs) using logistic regression in which use of IOP-lowering medications was regressed against known confounders (disorders during pregnancy and other chronic comorbidities). We then conducted logistic regression in which neonatal adverse outcomes were regressed against use of IOP-lowering medications with adjustment for the PS. Results We identified 826 eligible women, 91 (11%) of whom had received any IOP-lowering medications. CA occurred in 9.9% and 6.4%, PB in 2.2% and 4.5%, LBW in 9.9% and 6.0% and composite outcome in 17.6% and 13.3% of mothers with and without IOP-lowering medications, respectively. After adjustment for PS, IOP-lowering medications were not significantly associated with more frequent CA (adjusted OR (aOR), 1.43; 95% CI, 0.66 to 3.12), PB (aOR, 0.45; 95% CI, 0.10 to 1.97), LBW (aOR, 2.11; 95% CI, 0.98 to 4.57) or composite outcome (aOR, 1.40; 95% CI, 0.78 to 2.53). Results were similar regarding PGs only and beta-blockers only. Conclusions IOP-lowering medications during the first trimester were not significantly associated with increase in CA, PB or LBW.