Outpatient use of cardiovascular drugs during pregnancy
Outpatient use of cardiovascular drugs during pregnancy
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DOI：
10.1002/pds.1550
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发表时间：
2008-03-01
影响因子：
2.6
通讯作者：
Platt, Richard
中科院分区：
文献类型：
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作者：
Andrade, Susan E.;Raebel, Marsha A.;Platt, Richard
目的提供美国孕妇门诊使用心血管药物的情况，其中一些药物可能具有胎儿毒性或致畸作用。方法使用HMO研究网络治疗教育和研究中心(CERT)参与的7个健康计划的自动数据库进行回顾性研究。确认了2001年1月1日至2005年12月31日期间分娩的妇女的身份。结果2001-2005年间，118 935例分娩符合研究标准，3.1%的孕妇(N=3672)服用了降压药，0.12%的孕妇(N=146)在妊娠期的任何时候都服用了降血脂药。妊娠期间最常见的抗高血压药物是硝苯地平(1219次；1.0%)、甲基多巴(961次；0.8%)、阿替洛尔(593次；0.5%)和拉贝洛尔(576次；0.5%)。总体而言，134名妇女(0.11%)在怀孕期间接受了血管紧张素转换酶抑制剂，7名妇女(0.006%)接受了血管紧张素11受体阻滞剂。他汀类药物是最常见的抗高脂血症药物(71次分娩；0.06%)。结论在这群孕妇中，疑似胎儿毒性或致畸的心血管药物(ACE抑制剂、ARB和他汀类药物)的使用率较低。不同健康计划的不同使用模式表明，需要进一步研究，以评估心血管药物的潜在差异影响，以帮助处方医生和患者做出知情的治疗决定。版权所有(C)2008 John Wiley&Sons，Ltd.
Purpose To provide information on the prevalence of use of cardiovascular drugs, some of which may have fetotoxic or teratogenic effects, in the outpatient setting among pregnant women in the United States.Methods A retrospective study was conducted using the automated databases of seven health plans participating in the HMO Research Network Center for Education and Research on Therapeutics (CERT). Women who delivered an infant from I January 2001 to 31 December 2005 were identified. Cardiovascular drug use was evaluated assuming a gestational duration of 270 days.Results During the period 2001 through 2005, 118 935 deliveries were identified that met the criteria for study; 3.1% of women (N = 3672) were dispensed an anti hypertensive medication and 0.12% of women (N = 146) were dispensed an antihyperlipidemic medication at any time during pregnancy. The most common antihypertensive drugs dispensed during pregnancy were nifedipine (1219 deliveries; 1.0%), methyldopa (961 deliveries; 0.8%), atenolol (593 deliveries; 0.5%), and labetalol (576 deliveries; 0.5%). Overall, 134 women (0.11%) received an angiotensin converting enzyme (ACE) inhibitor and 7 women (0.006%) received an angiotensin 11 receptor blocker (ARB) during pregnancy. Statins were the most commonly dispensed antihyperlipidemic drugs (71 deliveries; 0.06%).Conclusions The prevalence of use of cardiovascular drugs that are suspected to be fetotoxic or teratogenic (ACE inhibitors, ARBs, and statins) was low in this cohort of pregnant women. Differing patterns of use across health plans suggests that further research is needed to evaluate the potential differential effects of cardiovascular drugs to assist prescribers and patients in making informed treatment decisions. Copyright (c) 2008 John Wiley & Sons, Ltd.