妊娠期用药对孕产妇妊娠结局影响及随访研究

Influence of Pregnancy Medication on Maternal Pregnancy Outcomes and Follow-up Study

关键词:  妊娠  用药  咨询  药学门诊  风险评估

Key words:  pregnancy  medication  consultation  pharmacy clinic  risk assessment

摘要:

目的 探讨孕产妇妊娠期用药现状及用药安全性，探索妊娠期药物咨询门诊的工作模式和数据积累。方法 将2021年10月—2022年12月在浙江大学医学院附属第一医院妊娠哺乳期用药咨询门诊所有接诊的孕产妇作为研究对象，记录其姓名、年龄、联系方式、末次月经以及妊娠期的药物使用情况，评估研究人群的用药概况及用药安全性，并对使用药物风险进行分析，整理临床药师的干预措施并对其妊娠结局进行随访研究。结果 经过筛选共纳入179名咨询孕产妇，研究人群中80%的患者是在未知妊娠状态下使用了药物，人均用药3种，最常见的用药原因为上呼吸道感染，使用率最高的3类药物为中成药、抗菌药及解热镇痛药。研究人群B级药物的使用率最高，占51.3%；有8.4%的患者使用了X级药物。完成随访151例，失访率15.6%，药师给予的药物风险评估建议患者接受率为95.4%，98.7%的患者认为妊娠咨询门诊对其有帮助且能有效缓解焦虑。结论 妊娠期药物咨询门诊能向患者提供科学的、个性化的用药指导和科普宣教，在缓解孕产妇焦虑、抑郁的方面也有显著效果。

Abstract:

OBJECTIVE To explore the current status and safety of medication in pregnant patients, and explore the working mode and data accumulation of the pregnancy medication consultation clinic. METHODS All pregnant women who received consultations at the Pregnancy and Lactation Medication Consultation Clinic of the First Affiliated Hospital of Zhejiang University School of Medicine from October 2021 to December 2022 were selected as the study subjects. Their names, ages, contact information, last menstrual period, and medication use during pregnancy were recorded, and the medication profile and safety of the study population were evaluated. Organized the intervention measures of clinical pharmacists and conducted follow-up studies on their pregnancy outcomes. RESULTS A total of 179 consultation pregnant women were included, and 80% of the patients in the study population used drugs in the unknown pregnancy state, with 3 drugs per capita. The most common reason for drug use was upper respiratory tract infection. The three types of drugs with the highest use rate were traditional Chinese patent medicines, antibacterial drugs, antipyretic and analgesic drugs. The usage rate of B-grade drugs in the study population was the highest, accounting for 51.3%; 8.4% of patients used X-grade medication. One hundred and fifty-one cases were followed up, with a loss of follow-up rate of 15.6%. The recommended acceptance rate of drug risk assessment given by pharmacists for patients was 95.4%. There were 98.7% of patients believe that pregnancy counseling clinics were helpful and could effectively alleviate anxiety. CONCLUSION Pregnancy medication consultation clinics can provide patients with scientific and personalized medication guidance and popular science education, and have significant effects in alleviating anxiety and depression in pregnant women.