妊娠期药学门诊的实践与分析  

Practice and analysis of pharmacy clinics during pregnancy

作　　者：陈万杰 施益金 李倩楠 李海娟 顾锦华[1,2,3] CHEN Wanjie;SHI Yijin;LI Qiannan;LI Haijuan;GU Jinhua(Department of pharmacy,Affiliated Maternity and Child Health Care Hospital of Nantong University(Nantong Children's Hospital),Jiangsu Nantong 226007,China;Department of Clinical Pharmacy,School of Pharmacy,Nantong University,Jiangsu Nantong 226019,China;Nantong Institute of Genetics and Reproductive Medicine,Jiangsu Nantong 226007,China)

机构地区：[1]南通大学附属妇幼保健院(南通市儿童医院)药学部,江苏南通226007 [2]南通大学药学院临床药学系,江苏南通226019 [3]南通市遗传与生殖医学研究所,江苏南通226007

出　　处：《中国医院药学杂志》2025年第2期215-219,共5页Chinese Journal of Hospital Pharmacy

基　　金：南通市社会民生发展科技计划项目(编号:MSZ2022097)。

摘　　要：目的:总结孕期人群用药现状和特征,分析影响妊娠结局的药物因素,指导妊娠期药学门诊工作开展。方法:将2021年1月至2022年8月在南通大学附属妇幼保健院就诊妊娠期药学门诊的咨询者作为研究对象,开展用药风险评估并对目标人群进行随访;收集药物暴露、妊娠结局、新生儿情况等信息资料,分析影响咨询者选择继续妊娠的风险因素,并对禁用药物、男性用药、叶酸补充与不良妊娠结局的相关性进行分析。结果:共收集420例咨询案例;93.98%的孕妇在未知妊娠的情况下用药,涉及药物412种;使用频率最高的是抗感染药(21.75%);36.14%的孕妇有禁用药物(共89种)暴露。成功随访的359例咨询者中,26.46%的放弃继续妊娠,240例顺利分娩,仅1例新生儿出现异常。既往生育次数影响了咨询者继续妊娠的选择(OR=0.49,95%CI:0.32~0.76,P=0.002)。研究涉及男性用药24例,12例活产子代均无异常。66.85%的孕妇增补过叶酸,其中68.75%的在孕1个月后才开始补充。结论:咨询人群大都在未知妊娠状态下用药,涉及药物种类繁多,但女性和男性用药与子代畸形的发生均未见明显关联。咨询人群叶酸增补率仍偏低,药师需继续通过药学门诊等途径,提高育龄人群的药学素养,为科学临床决策提供参考。OBJECTIVE To summarize the current status and characteristics of medication use in pregnant women,and to analyze medication factors affecting pregnancy outcomes,thus guiding the work of pharmacy clinics during pregnancy.METHODS Patients attending the pharmacy clinics during pregnancy of Affiliated Maternity and Child Health Care Hospital of Nantong University from January 2021 to August 2022 were taken as the study subjects.Medication risk assessment was carried out and the target population was followed up.Data of medication exposure,pregnancy outcomes,and neonatal conditions were collected.Risk factors influencing the decision to continue the pregnancy among the consultees were analyzed.Additionally,the correlation of the use of contraindicated medications,male partner medication use,and folic acid supplementation with adverse pregnancy outcomes was examined.RESULTS A total of 420 counselling cases were collected.93.98% of pregnant women used medication without knowing that they were pregnant,involving 412 types of medications.The most frequently used drugs were anti-infectives(21.75%).36.14% of pregnant women were exposed to 89 prohibited drugs.Among the 359 successfully followed-up cases,26.46% abandoned the continuation of the pregnancy,240 cases resulted in successful deliveries,and only 1newborn exhibited abnormalities.The number of previous pregnancies significantly influenced the decision to continue pregnancy among consultees(OR=0.49,95% CI:0.32-0.76,P=0.002).The study involved 24 cases of male medication users with all 12 live births showing no abnormalities.66.85% of pregnant women were supplemented with folic acid,of which 68.75% started supplementation after the first month of pregnancy.CONCLUSION Most of the counsellors used medication without knowing they were pregnant,involving a wide range of drugs,yet no significant association was seen between drug use and offspring malformations in either females or males.The supplementation rate of folic acid among consultees was relatively low.It is importa

关 键 词：妊娠期 药学门诊 孕期用药 药物安全性 

分 类 号：R9844[医药卫生—药品]