妊娠期使用抗组胺药物的安全性探讨

Discussion on the Safety of Antihistamines Used During Pregnancy

抗组胺药物被广泛应用于各种变应性疾病、瘙痒性皮肤病、过敏性鼻炎等疾病的治疗。孕妇是过敏性疾病和妊娠呕吐的高发人群,妊娠妇女使用抗组胺药物是否会对胎儿造成损害,是值得探讨的问题。本文结合FDA最新版说明书、数据库以及近年来的临床研究数据,对妊娠妇女使用抗组胺药物的安全性展开全面分析,结果发现,妊娠期使用抗组胺药物与导致胎儿畸形之间不存在明确相关性,尽管有少数研究观察到微弱相关性,但仍需要进一步的人体安全性研究加以验证。妊娠期必须使用抗组胺药物时,抗过敏可首选二代抗组胺药氯雷他定或西替利嗪;治疗妊娠呕吐可首选多西拉敏,临床常与维生素B6联合使用。

Antihistamines are widely used in the treatment of various allergic diseases, itchy skin diseases, allergic rhinitis and other diseases. Pregnant women are a population group who has a high incidence of allergic diseases and pregnancy vomiting. It is worth exploring whether the use of antihistamines by pregnant women can cause damages to the fetus. In this paper, the safety of antihistamines used by pregnant women was comprehensively analyzed in combination with the latest information of the FDA, databases and clinical data in recent years. The results showed that there was no definite correlation between the use of antihistamines during pregnancy and the incidence of fetal malformations, and further human safety studies were needed even though a small number of studies were observed with weak correlations. When antihistamines must be used during pregnancy, the second generation antihistamines loratadine or cetirizine were the preferred choice for allergic diseases, and doxylamine was the preferred choice for pregnancy vomiting, often combined with vitamin B6.