长沙县农村孕妇孕期暴露C、D类药物状况及其影响因素研究

Research on the Influential Factors and the Occurrence of Exposure to C、D Drugs in Rural Pregnant Women in Changsha County

目的描述农村孕妇妊娠期使用C、D类药物的情况,探索使用药物的影响因素。方法对2005～2007年长沙县某医院妇幼保健科就诊的480份孕妇临床资料进行回顾性分析。结果①在480名孕妇中有25.2%孕妇孕期使用过药物,5.4%孕期使用C、D类药物。②自然流产史(aOR=4.77,95%CI:(1.96,11.60))和早孕反应(aOR=1.71,95%CI:(1.07,2.73))与孕期使用药物存在关联;自然流产史(aOR=7.23,95%CI:2.25～23.23)和生育年龄≥30岁(aOR=4.00,95%CI:1.05～15.30)与孕期使用C、D类药物相关。③尚未发现文化水平、既往史、人工流产史、胎次与使用C、D类药物之间存在关联。结论农村孕妇在孕期有一定程度使用C、D类药物;自然流产史是孕妇孕期使用药物及暴露于C、D类药物的重要影响因素;早孕反应与孕期用药有密切关系;生育年龄≥30岁暴露于C、D类药物的机会是生育年龄<25岁的4倍;需要密切注意C、D类药物的管理及合理应用。

Objective To describe the occurrence of exposure to prescription Food and Drag Administration （FDA） category C,D drugs in pregnant women in rural area, and to analyze the influential factors associated with such an exposure. Methods A retrospective study of the 480 pregnant women who gave birth in a hospital of Changsha County from 2005 to 2007 was carried out. Results （1） Among the 480 pregnant women,about 25.2% used one or more drugs during pregnancy and 5.4% of them had exposure to FDA category C and D drugs. （2）Women with natural miscarriage（aOR =4. 77,95%CI：1.96,11.60） and nausea and vomiting of pregnancy （ a OR = 1.71,95% CI： 1.07,2. 73 ） were close association with the pregnancy exposure to drugs, while women with natural miscarriage （aOR = 7.23,95 % CI： 2. 25,23.23 ） and maternal age ≥ 30 group （ aOR = 4. 00,95% CI ： 1.05, 15.30 ） were significantly associated with pregnancy exposure to FDA category C and D drugs. （3）Educational background, disease history, artificial abortion frequency and parity were not associated with the exposure of C,D drugs during this study. Conclusion Pregnant women in rural area were moderate in exposure to FDA category C and D drugs in our study ; Natural miscarriage was an very important factor related to FDA category C and D drugs. Women who were more than 30 years old had fourfold at increased risk of exposure to drugs than that of women were less than 25 years old. It is necessary to focus on the management and rational use of FDA category C、D drugs closely for pregnant women.