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Second-generation antipsychotics and pregnancy complications.

第二代抗精神病药与妊娠并发症。

  • 影响因子:2.71
  • DOI:10.1007/s00228-019-02769-z
  • 作者列表:"Ellfolk M","Leinonen MK","Gissler M","Lahesmaa-Korpinen AM","Saastamoinen L","Nurminen ML","Malm H
  • 发表时间:2020-01-01
Abstract

PURPOSE:To study if second-generation antipsychotic (S-GA) use during pregnancy is associated with an increased risk of pregnancy and neonatal complications. METHODS:A population-based birth cohort study using national register data extracted from the "Drugs and Pregnancy" database in Finland, years 1996-2016. The sampling frame included 1,181,090 pregnant women and their singleton births. Women were categorized into three groups: exposed to S-GAs during pregnancy (n = 4225), exposed to first-generation antipsychotics (F-GAs) during pregnancy (n = 1576), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 21,125). Pregnancy outcomes in S-GA users were compared with those in the two comparison groups using multiple logistic regression models. RESULTS:Comparing S-GA users with unexposed ones, the risk was increased for gestational diabetes (adjusted odds ratio, OR 1.43; 95% CI 1.25-1.65), cesarean section (OR 1.35; 95% CI 1.18-1.53), being born large for gestational age (LGA) (OR 1.57; 95% CI 1.14-2.16), and preterm birth (OR 1.29; 95% CI 1.03-1.62). The risk for these outcomes increased further with continuous S-GA use. Infants in the S-GA group were also more likely to suffer from neonatal complications. Comparing S-GA users with the F-GA group, the risk of cesarean section and LGA was higher (OR 1.25, 95% CI 1.03-1.51; and OR 1.89, 95% CI 1.20-2.99, respectively). Neonatal complications did not differ between the S-GA and F-GA groups. CONCLUSIONS:Prenatal exposure to S-GAs is associated with an increased risk of pregnancy complications related to impaired glucose metabolism. Neonatal problems are common and occur similarly in S-GA and F-GA users.

摘要

目的: 研究在怀孕期间使用第二代抗精神病药物 (S-GA) 是否与妊娠和新生儿并发症的风险增加有关。 方法: 一项基于人群的出生队列研究,使用从芬兰 “药物和妊娠” 数据库中提取的国家登记数据,1996-2016 年。抽样框架包括 1,181,090 名孕妇及其单胎分娩。女性被分为三组: 孕期暴露于 S-GAs (n = 4225),孕期暴露于第一代抗精神病药物 (F-GAs) (n = 1576), 和未暴露 (怀孕期间不购买 S-GAs 或 F-GAs,n = 21,125)。使用多元 logistic 回归模型比较 S-GA 使用者与两个对照组的妊娠结局。 结果: S-GA 使用者与未暴露者相比,妊娠糖尿病 (校正比值比,OR 1.43; 95% CI 1.25-1.65) 、剖宫产 (OR 1.35) 的风险增加; 95% CI 1.18-1.53) 、出生胎龄大 (LGA) (OR 1.57; 95% CI 1.14-2.16) 和早产 (OR 1.29;95% CI 1.03-1.62)。随着 S-GA 的持续使用,这些结局的风险进一步增加。S-GA 组的婴儿也更容易发生新生儿并发症。比较 S-GA 使用者与 F-GA 组,剖宫产和 LGA 的风险更高 (OR 1.25,95% CI 1.03-1.51; 和 OR 1.89, 95% CI 分别为 1.20-2.99)。S-GA 组和 F-GA 组之间的新生儿并发症没有差异。 结论: 产前暴露于 S-GAs 与糖代谢受损相关的妊娠并发症风险增加有关。新生儿问题很常见,在 S-GA 和 F-GA 用户中发生相似。

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作者列表:["Alhayo S","Leonardi M","Lu C","Gosal P","Reid S","Barto W","Condous G"]

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发表时间:2020-01-10
DOI:10.1007/s00261-019-02399-0
作者列表:["Burnett TL","Feldman MK","Huang JQ"]

METHODS::Minimally invasive surgery for complex endometriosis requires preoperative planning that intimately connects the gynecologic surgeon to the radiologist. Understanding the surgeon's perspective to endometriosis treatment facilitates a productive relationship that ultimately benefits the patient. We examine minimally invasive surgery for endometriosis and the key radiologic information which enable the surgeon to successfully negotiate patient counseling, preoperative planning, and an interdisciplinary approach to surgery.

影响因子:1.69
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DOI:10.1016/j.jmig.2020.01.002
作者列表:["Byun J","Peterson CM","Backonja U","Taylor RN","Stanford JB","Allen-Brady KL","Smith KR","Buck Louis GM","Schliep KC"]

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