初级保健中育龄2型糖尿病妇女的药物处方和妊娠相关危险因素：prep研究的横断面调查

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2025-03-05 DOI:10.1136/bmjdrc-2024-004312

Alexandra M Famiglietti, Judith Parsons, Kia-Chong Chua, Anna Hodgkinson, Olubunmi Abiola, Anna Brackenridge, Anita Banerjee, Mark Chamley, Lily Hopkins, Katharine F Hunt, Helen Murphy, Helen Rogers, Gavin Steele, Kirsty Winkley, Angus Forbes, Rita Forde

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引用次数: 0

摘要

导读：患有2型糖尿病的妇女在使用不推荐用于妊娠的药物或已知具有致畸性的药物时，有开始妊娠的风险，这可能导致不良妊娠结局。在这项研究中，我们的目的是描述怀孕相关的危险因素和2型糖尿病妇女的药物暴露。研究设计和方法：个人健康特征、社会人口学信息和处方数据提取自英国18-45岁2型糖尿病妇女参加全科医生的初级保健记录。处方药物根据妊娠适宜性分类：推荐，不推荐，或不推荐，但如果临床指征使用。Logistic回归用于估计个体特征与不推荐用于妊娠的药物之间的关联。结果：共提取725例妇女资料。处方药物表明存在许多合并症，其中最常见的是糖尿病药物（65%,n=471）和他汀类药物（20%,n=145）。37% （n=268）的妇女服用了3种以上的药物，三分之一（n=269）的妇女服用了不推荐用于妊娠的药物。在未开处方避孕的患者中（89%,n=646），没有人符合所有临床推荐的孕前标准。在多变量logistic回归分析中，多药（OR 3.49 95% CI 2.88 ~ 4.30）和年龄（OR 1.04 95% CI 1.00 ~ 1.09）与孕期不推荐用药相关。结论：2型糖尿病妇女尽管多次服用不推荐用于妊娠的药物，其避孕措施仍不理想。在初级保健机构中，迫切需要定期评估避孕药具的使用、生育意图和药物审查，以尽量减少与妊娠有关的风险。

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Medication prescribing and pregnancy-related risk factors for women with type 2 diabetes of reproductive age within primary care: a cross-sectional investigation for the PREPARED study.

Introduction: Women with type 2 diabetes are at risk of commencing pregnancy while using medications that are either not recommended for pregnancy or with known teratogenicity, which may contribute to adverse pregnancy outcomes. In this study, we aimed to characterize pregnancy-related risk factors and medication exposures among women with type 2 diabetes.

Research design and methods: Individual health characteristics, sociodemographic information, and prescription data were extracted from the primary care records of women aged 18-45 years with type 2 diabetes in participating general practices in the UK. Prescribed medications were categorized according to suitability for pregnancy: recommended, not recommended, or not recommended but used if clinically indicated. Logistic regression was used to estimate associations between individual characteristics and medications not recommended for pregnancy.

Results: Data on 725 women were extracted. Prescribed medications suggested the presence of numerous comorbidities, with diabetes medications (65%, n=471) and statins (20%, n=145) most frequently prescribed. 37% (n=268) of women took ≥3 medications, and a third (n=269) took medications not recommended for pregnancy. Among those not prescribed contraception (89%, n=646), no one met all clinically recommended pre-pregnancy criteria. In multivariable logistic regression analysis, polypharmacy (OR 3.49 95% CI 2.88 to 4.30) and age (OR 1.04 95% CI 1.00 to 1.09) were associated with use of medications not recommended for pregnancy.

Conclusions: Women with type 2 diabetes have suboptimal contraceptive provision despite multiple exposures to medications not recommended for pregnancy. Regular assessment of contraceptive use, reproductive intentions, and medication review is urgently needed in primary care settings to minimize pregnancy-related risks.

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.