Use of disease-modifying antirheumatic drugs during pregnancy and risk of preeclampsia.
Use of disease-modifying antirheumatic drugs during pregnancy and risk of preeclampsia.
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DOI：
10.1002/acr.21807
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发表时间：
2012-11
影响因子：
4.7
通讯作者：
Setoguchi, Soko
中科院分区：
文献类型：
--
作者：
Palmsten, Kristin;Hernandez-Diaz, Sonia;Kuriya, Bindee;Solomon, Daniel H.;Setoguchi, Soko
描述以人群为基础的队列中妊娠期间疾病改善抗风湿药物（DMARD）使用模式，并评估自身免疫性疾病（AD）、DMARD、皮质类固醇和非甾体抗炎药与先兆子痫之间的关系。使用不列颠哥伦比亚省（1997-2006）的医疗保健利用数据库，我们比较了44,786名患有和未患有AD的妇女在怀孕前（过去服用者）和妊娠前20周（持续服用者）使用研究药物配药的先兆子痫的风险。估计相对危险度（RR）和95%置信区间（CI）。只有414名（0.1%）妇女在怀孕期间服用了DMARD。既往使用DMARD者子痫前期发生率为2.3%，既往使用皮质类固醇者为2.7%，既往使用非甾体抗炎药者为2.9%。与过去的使用者相比，持续使用DMARD的RR为2.29 (CI: 0.81-6.44)，皮质类固醇的RR为0.89 (CI: 0.51-1.56)，非甾体抗炎药（NSAID）的RR为0.84 （CI: 0.63-1.10）。与无AD的女性相比，系统性红斑狼疮（SLE）女性的分娩年校正RR为2.02 （CI: 1.11-3.64）。当排除抗疟药物时，DMARD结果减弱，当DMARD分析仅限于AD妇女时，分娩年调整RR为0.95 （CI: 0.25-3.55）。很少有妇女在怀孕期间接触到DMARDs。我们观察到SLE患者的先兆子痫风险增加了两倍，而DMARD使用者的风险没有显著增加。当排除抗疟疾药物时，DMARD和先兆子痫的关联减弱，而当仅限于患有AD的女性时，这种关联为零，这表明这种关联可能是由于DMARD使用者的AD严重程度更高。
Describe patterns of Disease-Modifying Antirheumatic Drug (DMARD) use during pregnancy in a population-based cohort, and evaluate the association between autoimmune disease (AD), DMARDs, corticosteroids and NSAIDs, and preeclampsia. Using healthcare utilization databases from British Columbia (1997–2006), we compared the risk for preeclampsia among 44,786 women with and without AD with study drug dispensings before pregnancy (past users) and before and during the first 20 gestational weeks (continuous users). Relative risks (RR) and 95% confidence intervals (CI) were estimated. Only 414 (0.1%) women had a DMARD dispensing during pregnancy. The incidence of preeclampsia was 2.3% for past DMARD, 2.7% for past corticosteroid, and 2.9% for past NSAIDs users. Compared to past users, the continuous DMARD user RR was 2.29 (CI: 0.81–6.44), and was 0.89 (CI: 0.51–1.56) for corticosteroid and 0.84 (CI: 0.63–1.10) for NSAID users. Compared to women without AD, the delivery year-adjusted RR was 2.02 (CI: 1.11–3.64) for women with systemic lupus erythematosus (SLE). The DMARD results were attenuated when antimalarials were excluded and the delivery-year adjusted RR was 0.95 (CI: 0.25–3.55) when the DMARD analysis was restricted to women with AD. Few women were exposed to DMARDs during pregnancy. We observed a two-fold increased risk of preeclampsia among women with SLE and a non-significant increase in the risk in DMARD users. The DMARD and preeclampsia association was attenuated when anti-malarials were excluded and null when restricted to women with AD, which suggests the association is likely due to greater AD severity in DMARD users.
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影响因子：
29.4
作者：
Mahadevan, Uma;Sandborn, William J.;Corley, Douglas A.
通讯作者：
Corley, Douglas A.
影响因子：
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作者：
Duckitt, K;Harrington, D
通讯作者：
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Bowes, WA
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Kelly, Victoria M.;Nelson, Lorene M.;Chakravarty, Eliza F.
通讯作者：
Chakravarty, Eliza F.
影响因子：
4.7
作者：
Daleboudt, Gabrielle M. N.;Broadbent, Elizabeth;Kaptein, A.
通讯作者：
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