哮喘联盟

   摘要
   背景：研究提示孕期产妇抑郁症与后代哮喘发病率有关，但抗抑郁治疗与后代哮喘发病率的关系尚不明确。我们旨在调查孕期抗抑郁药物的使用是否会增加后代患哮喘的风险。
   方法：对1996年至2007年间出生于丹麦的所有单胎个体进行队列研究。患有抑郁症和/或在妊娠前一年或在孕期服用过抗抑郁药物的母亲被纳入研究。运用Cox比例风险回归模型评估孕期使用抗抑郁药物患者的后代哮喘发病的风险比 (HR) 。
   结果：总计733685名儿童被纳入研究，其中有84683名被诊断为哮喘患者。总计21371名儿童暴露于产前母亲抑郁（如诊断为抑郁症或产前1年或孕期中使用过抗抑郁药物）。母亲产前抑郁与儿童哮喘发病相关 （HR:1.25 [95%置信区间(CI):1.20-1.30]）。总体而言，有8895名儿童暴露于宫内抗抑郁药物。比较母亲患有产前抑郁症和孕期无抗抑郁药使用的儿童，孕期使用抗抑郁药儿童患哮喘的风险比为1.00 （95%CI: 0.93-1.08）。仅使用选择性血清再吸收抑制剂、仅使用较新的抗抑郁药和仅使用旧的抗抑郁药的 风险比分别为0.95 (95% CI: 0.88-1.03), 1.11 (95% CI: 0.89-1.39), 和1.26 (95% CI: 1.02-1.55)。
   结论：孕期使用抗抑郁药普遍不增加哮喘风险。只有使用旧的抗抑郁药与哮喘风险增加有关。
 

（苏欣 审校）
Pediatrics. 2015 Mar 9. pii: peds.2014-4073. [Epub ahead of print]

 

Antidepressant Use During Pregnancy and Asthma in the Offspring.
 

Liu X1, Olsen J2, Pedersen LH3, Agerbo E4, Yuan W5, Li J6.

Author information
 

ABSTRACT
BACKGROUND AND OBJECTIVES:It has been suggested that maternal depression during pregnancy is associated with asthma in the offspring, but the role of medical treatment of depression is not known. Our goal was to examine whether prenatal antidepressant use increases the risk of asthma in the offspring.
METHODS:A cohort study was performed among all live singletons born in Denmark between 1996 and 2007. Mothers who had a diagnosis of depressive disorder and/or who used antidepressants 1 year before or during the index pregnancy were identified. Using a Cox proportional hazards regression model, we estimated the hazard ratio (HR) for asthma in the offspring after antidepressant use during pregnancy.
RESULTS:Of the 733 685 children identified, 84 683 had a diagnosis of asthma. A total of 21 371 children were exposed to prenatal maternal depression (ie, a diagnosis of depressive disorder or use of antidepressants 1 year before or during pregnancy). Prenatal maternal depression was associated with childhood asthma (HR: 1.25 [95% confidence interval (CI): 1.20-1.30]). Overall, 8895 children were exposed to antidepressants in utero. Compared with children born to mothers with prenatal depression and no antidepressant use during pregnancy, the HR for asthma after any antidepressant use during pregnancy was 1.00 (95% CI: 0.93-1.08). HRs after use of selective serotonin reuptake inhibitors only, newer antidepressants only, and older antidepressants only were 0.95 (95% CI: 0.88-1.03), 1.11 (95% CI: 0.89-1.39), and 1.26 (95% CI: 1.02-1.55), respectively.
CONCLUSIONS:Antidepressant use during pregnancy generally did not increase the risk of asthma. Only use of older antidepressants was associated with an increased risk of asthma.
 

Pediatrics. 2015 Mar 9. pii: peds.2014-4073. [Epub ahead of print]