β受体阻滞药对患有心脏病的孕妇分娩小于胎龄儿影响的临床研究  

Clinical trial on the effect of beta-blockers on delivery of preterm infants in pregnant women with heart disease

作　　者：吴小妹[1] 李慧[1] 王丽 欧曼颖 胡春霞[1] WU Xiao-mei;LI Hui;WANG Li;OU Man-ying;HU Chun-xia(Obstetrics Department,The First Affiliated Hospital of Hainan Medical College,Haikou 571000,Hainan Province,China)

机构地区：[1]海南医学院第一附属医院产科,海南海口571000

出　　处：《中国临床药理学杂志》2023年第12期1684-1688,共5页The Chinese Journal of Clinical Pharmacology

基　　金：海南省重点研发计划基金资助项目(ZDYF2019162)。

摘　　要：目的 探究产前使用β受体阻滞药和剂量与患有围生期心脏病孕妇分娩小于胎龄儿风险的相关性。方法 回顾性分析患有围生期心脏病孕妇病历资料,根据是否使用过β受体阻滞药把受试者分为β受体阻滞药组(根据给药剂量再分为β受体阻滞药低剂量组、β受体阻滞药高剂量组)和未使用β受体阻滞药组。比较各组孕妇分娩小于胎龄儿的风险,使用逻辑回归模型分析各关键因素造成小于胎龄儿的风险比。结果 β受体阻滞药组和未使用β受体阻滞药组分别纳入82例(30.37%)和188例(69.63%)。β受体阻滞药组和未使用β受体阻滞药组患者分娩的胎儿体质量分别为(3 010±677)和(3 358±566)g;2组Z评分分别为(-0.52±0.93)和(-0.24±0.86)分;2组小于胎龄儿的比例分别为20.24%和9.42%,2组上述指标比较,差异均有统计学意义(均P<0.05)。高剂量β受体阻滞药的使用与分娩小于胎龄儿的高风险有关(OR=3.1,P<0.05),而低剂量β受体阻滞药的使用虽然也会增加风险,但差异无统计学意义(OR=1.6,P>0.05)。结论 患有心脏病的孕妇在接受高剂量β受体阻滞药治疗时,增加分娩小于胎龄儿的风险,呈现出明显的剂量-反应关系。Objective This study aimed to investigate the relationship between the use and dosage of beta-blockers during pregnancy and the risk of preterm birth in pregnant women with cardiovascular disease.Methods A retrospective analysis was conducted on the medical records of pregnant women with perinatal heart disease.The patients were divided intoβ-blocker group(further divided into low dose and high dose group based on the dosage levels)and a non-β-blocker group based on whether they usedβ-blockers.The risk of preterm delivery among the groups of pregnant women was compared,and a logistic regression model was used to analyze the key factors that contributed to the risk of preterm delivery.Results A total of 82(30.37%)and 188(69.63%)subject were included in theβ-blocker and non-β-blocker groups,respectively.The fetal birth weight in theβ-blocker group and the non-β-blocker group were(3010±677)g and(3358±566)g,respectively.The Z score in theβ-blocker ang non-β-blocker groups were(-0.52±0.93)and(-0.24±0.86),respectively,and the proportion of preterm births in the two groups were 20.24%and 9.42%,respectively.The differences between the two groups were statistically significant(P<0.05).The use of high-doseβ-blockers was associated with a higher risk of preterm birth(OR=3.1,P<0.05),while the use of low-doseβ-blockers also increased the risk,but without significance(OR=1.6,P>0.05).Conclusion Pregnant women with heart disease increase the risk of small for gestational age when receiving high-doseβ-blockers,showing a significant dose-response relationship.

关 键 词：Β受体阻滞药 小于胎龄儿 心脏病 孕妇 

分 类 号：R972[医药卫生—药品]