胎兒在子宮內受Indomethacin的暴露顯然相當安全


  Oct. 10, 2003-根據一項發表於九月份美國婦產科學期刊(the American Journal of Obstetrics and Gynecology)的回溯性研究結果顯示,出生前暴露於indomethacin並不會增加新生兒的併發症。
  
  美國費城賓夕法尼亞州立大學醫學院的Soraya Abbasi博士及其同事表示,Indomethacin是一種強效的前列腺抑制劑,已被成功當作產科用藥超過20年之久,然而indomethacin卻會通過胎盤且對多數的胎兒器官造成影響。
  
  在這項個案世代研究中,出生前暴露於indomethacin的124位新生兒以出生時的懷孕週數、性別及產前受到betamethasone暴露為基準,與母親未接受indomethacin治療的124位新生兒進行匹配。
  
  出生體重、Apgar score、剖腹產的頻率、多胞胎、呼吸窘迫症候群、介面活性劑治療的需求、開放性動脈導管、壞死性腸炎或是腦室內出血在兩組族群中皆無明顯差異,作者提到此項研究會受到和之前研究相同的回溯性設計所固有的可能性選擇誤差的影響。
  
  在這項研究中,Indomethacin的暴露與最近暴露在48小時內或更久後出生的嬰兒之新生兒併發症的增加並沒有相關性,但還需要以indomethacin做為主要產科用藥的適當分類前瞻性試驗來確定出生前indomethacin療法的安全性,在這期間,這項研究及其他數個相關報告指出,只要謹慎使用indomethacin,將不會對新生兒造成任何的風險。

In Utero Exposure to Indometha

By Laurie Barclay, MD
Medscape Medical News

Oct. 10, 2003 — In utero exposure to indomethacin does not increase neonatal complications, according to the results of a retrospective study published in the September issue of the American Journal of Obstetrics and Gynecology.

"Indomethacin is a potent prostaglandin inhibitor that has been used successfully as a tocolytic agent for more than 20 years," write Soraya Abbasi, MD, from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues. "However, indomethacin crosses the placenta and affects multiple fetal organs."

In this case-cohort study, 124 infants with in utero exposure to indomethacin were matched on the basis of gestational age at birth, sex, and exposure to antenatal betamethasone to 124 infants whose mothers did not receive indomethacin.

There were no significant differences between groups in birth weight, Apgar score, frequency of cesarean section delivery, multiple gestation, respiratory distress syndrome, need for surfactant treatment, patent ductus arteriosus, necrotizing enterocolitis, or intraventricular hemorrhage.

Compared with their matched controls, incidence of respiratory distress syndrome was similar in 62 cases born within 48 hours of last exposure to indomethacin. However, they had a greater need for surfactant treatment (P = .02). Rates of all other complication rates were similar between groups.

The authors note that this study as well as previous studies suffer from possible selection bias inherent in their retrospective design.

"Indomethacin exposure in our study was not associated with increased neonatal complications for infants delivered within or beyond 48 hours of last exposure," they write. "An appropriately sized prospective, randomized trial with indomethacin as primary tocolytic agent would be required to determine the safety of antenatal indomethacin treatment. Meanwhile, the data in this and several other reports indicate that the cautious use of indomethacin should incur minimal, if any, risk to the neonate."

Am J Obstet Gynecol. 2003;189:782-785

Reviewed by Gary D. Vogin, MD

    
相關報導
懷孕期間父親的憂鬱症狀可能預期會有嬰兒過度哭鬧
2009/7/16 上午 10:29:00
新的腦膜炎疫苗可以讓嬰兒有比較好的免疫力
2008/1/18 上午 10:32:00
罹患先天性心臟病嬰兒有廣泛性的腦部異常
2007/11/29 下午 05:40:00

上一頁
   1   2   3   4   5   6   7   8  




回上一頁