我国2013-2019年计划妊娠女性孕前用药特征分析

A descriptive analysis of prepregnancy medication among Chinese women with pregnancy intention during 2013-2019

目的:了解我国计划妊娠女性孕前用药特征,为孕前生殖健康促进提供数据支持。方法:以在2013-2019年参加国家免费孕前优生健康检查项目(NFPCP)且自报有服药史871152例计划妊娠女性为研究对象,以《国家基本药物目录(2018版)》为对照解析自报药物名称及其类别,最后使用描述性流行病学方法分析研究对象孕前用药特征,并使用卡方检验分析不同基线特征下各类别药物的分布差异。结果:有高达2.2%的计划妊娠女性报告服用药物,且服药种类复杂。孕前用药主要为维生素/矿物质类药物(64.1%),其他依次为妇产科与计划生育用药(7.5%)、抗微生物药物(6.8%)、激素及影响内分泌药(6.7%)、镇痛/解热/抗炎/抗风湿/抗痛风药(5.4%)和中药(5.0%)。高龄、汉族、高中以上文化程度、城镇户籍、非农民职业、经产妇、有不良妊娠史及超重肥胖者服用抗微生物药、激素及影响内分泌药、镇痛解热/抗炎/抗风湿/抗通风药及中药构成比较高。结论:孕前用药种类复杂,已对安全用药与健康咨询形成挑战。孕前健康咨询时,应关注高龄、汉族、高中以上学历、城镇户籍、除农民以外的其他职业、经产妇、不良妊娠结局史与超重肥胖女性服药情况,识别药物妊娠与胚胎毒性,降低药物相关不良妊娠结局事件发生风险。

Objective:To analyze medication among Chinese women with pregnancy intention,and to provide the data support for promoting the preconception health of the women.Methods:A total of 871152 women who had participated in the National Free Pre-pregnancy Checkups Project(NFPCP)and had self-reported medication during 2013-2019were included as the study objects.All the self-reported medications were parsed with the reference of National Essential Drugs List published in 2018.Descriptive epidemiological method was used to analyze the characteristics of the prepregnancy medication of the women,and Chi-square test was used to analyze the distribution differences of the medication according to the baseline characteristics.Results:Up to 2.2%of the women with planning pregnancy had reported medication usage,with a diverse range of drug types being reported.The prepregnancy medications primarily comprised of vitamin/mineral drugs(64.1%),followed by obstetrics,gynecology,and family planning drugs(7.5%),antimicrobials(6.8%),hormones and drugs influencing the endocrine system(6.7%),analgesic/antipyretic/anti-inflammatory/anti-rheumatic/anti-gout drugs(5.4%)and traditional Chinese herbal medicine(5.0%).The women with advanced age,Han nationality,high school education level above,urban household registration,non-farmer occupation,delivery history,history of adverse pregnancy,or overweight or obese had tend to have the higher usage rates of antimicrobial drugs,hormones,drugs influencing the endocrine system,analgesic and antipyretic/anti-inflammatory/anti-rheumatic/anti-gout drugs,and traditional Chinese herbal medicine.Conclusion:The diversity of prepregnancy medications is complex,and which is presenting challenges for ensuring the safe medication usage and the health counselling.During the pre-pregnancy health counselling,attention should be directed towards the medication usage among the women with advanced age,Han nationality,high school education level above,urban household registration,nonfarmer occupation,delivery history,history of adverse pregnancy,and overweight or obese.It is crucial for identifying the potential risks of medication-induced pregnancy and embryonic toxicity,thus decreasing the occurrence of the adverse pregnancy outcomes associated with the prepregnancy medication used of the women.