Согласно
результатам популяционного исследования, опубликованным на платформе PloS One,
только 1 из 4 женщин продолжает лечение триптанами на протяжении всей
беременности, а длительное применение триптанов наблюдается относительно редко.
Кроме того, женщины обычно прекращают прием триптанов во время беременности и в
течение года после родов. Целью данного исследования была оценка связи между
фармакотерапией мигрени до и во время беременности и после родов и применением
триптанов.
В
данном исследовании оценивали 22 940 случаев беременности у
19 669 женщин, которым как минимум 1 раз назначали триптаны для
лечения мигрени в течение года до наступления беременности или на протяжении
беременности. Участниц разделили на четыре группы: пациентки, продолжившие
лечение (20 %); пациентки, прекратившие лечение (54,1 %); пациентки,
начавшие лечение (8 %); и пациентки, возобновившие лечение после
родов (17,6 %). Была проведена оценка демографических характеристик
пациенток и назначений других лекарственных препаратов (противорвотные,
обезболивающие и профилактические средства), а также параметров применения
триптанов.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and
detection of IgM/IgG antibodies in blood samples. A significant difference in
the cumulative incidence of Coronavirus disease-19 between the case (21/102,
20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of spontaneous
and medically-indicated preterm birth due to pregnancy-related hypertension and
its complications (0.77; 95% confidence interval, 0.41-1.43). Pregnant patients
without comorbidities need to be reassured that asymptomatic/mild SARS-CoV-2
infection does not increase the risk of preterm delivery. Preterm birth and
severe Coronavirus disease-19 share common risk factors (i.e., body mass index
> 24.9, asthma, chronic hypertension), which may explain the high rate of
indicated preterm birth due to maternal conditions reported in the literature.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and
detection of IgM/IgG antibodies in blood samples. A significant difference in
the cumulative incidence of Coronavirus disease-19 between the case (21/102,
20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of
spontaneous and medically-indicated preterm birth due to pregnancy-related
hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43).
Pregnant patients without comorbidities need to be reassured that
asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm
delivery. Preterm birth and severe Coronavirus disease-19 share common risk
factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which
may explain the high rate of indicated preterm birth due to maternal conditions
reported in the literature.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and
detection of IgM/IgG antibodies in blood samples. A significant difference in
the cumulative incidence of Coronavirus disease-19 between the case (21/102,
20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of
spontaneous and medically-indicated preterm birth due to pregnancy-related
hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43).
Pregnant patients without comorbidities need to be reassured that
asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm
delivery. Preterm birth and severe Coronavirus disease-19 share common risk
factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which
may explain the high rate of indicated preterm birth due to maternal conditions
reported in the literature.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and
detection of IgM/IgG antibodies in blood samples. A significant difference in
the cumulative incidence of Coronavirus disease-19 between the case (21/102,
20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of
spontaneous and medically-indicated preterm birth due to pregnancy-related
hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43).
Pregnant patients without comorbidities need to be reassured that
asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm
delivery. Preterm birth and severe Coronavirus disease-19 share common risk
factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which
may explain the high rate of indicated preterm birth due to maternal conditions
reported in the literature.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and detection
of IgM/IgG antibodies in blood samples. A significant difference in the
cumulative incidence of Coronavirus disease-19 between the case (21/102, 20.5%)
and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of
spontaneous and medically-indicated preterm birth due to pregnancy-related
hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43).
Pregnant patients without comorbidities need to be reassured that
asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm
delivery. Preterm birth and severe Coronavirus disease-19 share common risk
factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which
may explain the high rate of indicated preterm birth due to maternal conditions
reported in the literature.
Evidence for the real impact of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on preterm birth is
unclear, as available series report composite pregnancy outcomes and/or do not
stratify patients according to disease severity. The purpose of the research
was to determine the real impact of asymptomatic/mild SARS-CoV-2 infection on
preterm birth not due to maternal respiratory failure. This case-control study
involved women admitted to Sant Anna Hospital, Turin, for delivery between 20
September 2020 and 9 January 2021. The cumulative incidence of Coronavirus
disease-19 was compared between preterm birth (case group, n = 102) and
full-term delivery (control group, n = 127). Only women with spontaneous or
medically-indicated preterm birth because of placental vascular malperfusion
(pregnancy-related hypertension and its complications) were included. Current
or past SARS-CoV-2 infection was determined by nasopharyngeal swab testing and
detection of IgM/IgG antibodies in blood samples. A significant difference in
the cumulative incidence of Coronavirus disease-19 between the case (21/102,
20.5%) and the control group (32/127, 25.1%) (P= 0.50) was not observed,
although the case group was burdened by a higher prevalence of three known risk
factors (body mass index > 24.9, asthma, chronic hypertension) for severe
Coronavirus disease-19. Logistic regression analysis showed that
asymptomatic/mild SARS-CoV-2 infection was not an independent predictor of
spontaneous and medically-indicated preterm birth due to pregnancy-related
hypertension and its complications (0.77; 95% confidence interval, 0.41-1.43).
Pregnant patients without comorbidities need to be reassured that
asymptomatic/mild SARS-CoV-2 infection does not increase the risk of preterm
delivery. Preterm birth and severe Coronavirus disease-19 share common risk
factors (i.e., body mass index > 24.9, asthma, chronic hypertension), which
may explain the high rate of indicated preterm birth due to maternal conditions
reported in the literature.
В первом триместре
6,9 % пациенток, продолживших лечение, применяли триптаны в большом объеме
(≥ 15 суточных доз препарата в месяц). Наиболее высокие показатели
применения триптанов были отмечены у 10 % пациенток из группы продолживших
лечение и группы начавших лечение — 41 % и 33 % соответственно.
У пациенток, продолживших лечение, и у пациенток, начавших лечение, наблюдались
сопоставимые характеристики приема других препаратов сопутствующей терапии для
купирования острых симптомов в период беременности. Тем не менее применение
профилактических средств чаще наблюдалось у пациенток, продолживших лечение, в
период до и во время беременности и после родов.
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