妊娠期口服抗精神病药物对子代生长发育的影响

Effects of oral antipsychotic drugs on growth and development of offspring during pregnancy

目的:观察抗精神病药物对精神分裂症妊娠患者的影响,为临床指导孕期用药提供理论依据。方法:选取120例合并精神分裂症的孕妇作为研究组,根据口服药物的种类不同分为A、B、C、D、E、F共六组,分别服用氯氮平、奥氮平、利培酮、阿立哌唑、喹硫平、齐拉西酮。另选20例健康孕妇作为对照组,无妊娠合并症,无长期服药史,无不良嗜好。统计七组研究对象妊娠期间流产、死胎等不良结局及新生儿健康状况,比较组间差异,分析抗精神病药物对精神分裂症患者妊娠的影响。结果:七组胎儿致畸率、自然流产率、巨大儿、死胎率、新生儿Apgar评分等无统计学差异(P>0.05);研究各组人工流产率和不良结局发生率略高于对照组,但差异无统计学意义(P>0.05);新生儿Apgar评分等组间比较无统计学差异(P>0.05)。结论:临床常用的六组抗精神病药物单一用药维持妊娠期精神分裂症患者的治疗,对子代生长发育影响与健康妊娠者相比无统计学差异。

Objective： To observe effects of antipsychotic drugs on pregnancy patients with schizophrenia,and to provide a theoretical basis for clinical guidance drug use during pregnancy. Methods： 120 pregnant patients with schizophrenia were selected as observation group and subdivided into A,B,C,D,E,F groups according to different kinds of oral medicines. Each group was treated with Olanzapine,Clozapine,Risperidone,Aripiprazole,Quetiapine,and Ziprasidone,separately. Another 20 cases of healthy subjects were chosen as control group without pregnancy complications,long-term drug-taking history and bad habits. The conditions of abortion,stillbirth,other adverse outcomes and neonatal health of the 7 groups during pregnancy were statistically analyzed and compared,and the effects of antipsychotics on the schizophrenia patients with pregnancy were analyzed. Results： There were no significant differences among the seven groups in the neonatal teratogenic rate,the rate of spontaneous abortion,fetal macrosomia rate,fetal death rate and neonatal Apgar score（ P〈0.05）. In addition,the rate of induced abortion and the rate of adverse outcome in the observation group were slightly higher than those in the control group,the differences were not significant（ P〈0.05）. There was no significant difference in the neonatal Apgar score among each group（ P〈0.05）. Conclusions： There is no statistically significant effect on the growth and development of the offspring for the majority of the schizophrenic patients with a single low dose maintenance therapy.