Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis
Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis
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DOI：
10.1016/s0029-7844(02)02001-x
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发表时间：
2002-07-01
影响因子：
7.2
通讯作者：
Griffin, MR
中科院分区：
文献类型：
--
作者：
Cooper, WO;Ray, WA;Griffin, MR
目的：评估大量婴儿中的产前抗生素（包括红霉素）与婴儿肥厚性幽门狭窄之间的关联。方法：这是一项针对 1985-1997 年加入田纳西州医疗补助/TennCare 的妇女分娩的回顾性队列研究。红霉素、非红霉素大环内酯类药物和其他抗生素的处方是从与出生证明文件相关的药房文件中确定的。主要研究结果是婴儿幽门狭窄的发生，通过相关的出院诊断和手术程序代码进行确定。结果：该队列包括 260,799 对母亲/婴儿。在这些女性中，有 13,146 人开出了红霉素处方（每 1000 人 50.4 人），621 人开出了非红霉素大环内酯类处方（每 1000 人 2.4 人）。妊娠 32 周后（调整后比值比 1.17，95% 置信区间 0.84, 1.64，P = .33）或怀孕期间的任何时间（调整后比值比 1.15，95% 置信区间 0.84，1.565 P = 0.33），产前红霉素处方与婴儿肥厚性幽门狭窄均无关联。 .36）。母亲服用非红霉素大环内酯类药物与婴儿肥厚性幽门狭窄之间存在关联（调整后的比值比 2.77，95% 置信区间 1.22，6.305 P = .01）。 结论：没有发现红霉素与婴儿幽门狭窄之间的假设关联。产前非红霉素大环内酯类药物与婴儿肥厚性幽门狭窄之间关联的因果推断受到受影响儿童数量较少以及非红霉素大环内酯类药物使用者和对照之间其他差异的证据的限制。 (C) 2002 年，美国妇产科医师学会。
OBJECTIVE: To assess the association between prenatal antibiotics, including erythromycin, and infantile hypertrophic pyloric stenosis in a large cohort of infants.METHODS: This was a retrospective cohort study of births to women enrolled in Tennessee Medicaid/TennCare, 1985-1997. Prescriptions for erythromycin, nonerythromycin macrolides, and other antibiotics were identified from pharmacy files linked with birth certificate files. The primary study outcome was development of pyloric stenosis in the infant, identified from linked hospital discharge diagnosis and surgical procedure codes.RESULTS: The cohort included 260,799 mother/infant pairs. Among these women, 13,146 filled prescriptions for erythromycin (50.4 per 1000), and 621 filled prescriptions for nonerythromycin macrolides (2.4 per 1000). There was no association with prenatal erythromycin prescription and infantile hypertrophic pyloric stenosis either after 32 weeks' gestation (adjusted odds ratio 1.17, 95% confidence interval, 0.84, 1.64, P = .33) or at any time during preg nancy (adjusted odds ratio 1.15, 95% confidence interval 0.84, 1.565 P = .36). There was an association between maternal prescriptions for nonerythromycin macrolides and infantile hypertrophic pyloric stenosis (adjusted odds ratio 2.77, 95% confidence interval 1.22, 6.305 P = .01).CONCLUSION: The hypothesized association between erythromycin and infantile pyloric stenosis was not seen. Causal inference from the association between prenatal nonerythromycin macrolides and infantile hypertrophic pyloric stenosis is limited by the small number of affected children and the evidence of other differences between users of nonerythromycin macrolides and controls. (C) 2002 by The American College of Obstetricians and Gynecologists.