國家衛生研究院 NHRI:Item 3990099045/15717
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    題名: Use of leukotriene-receptor antagonists during pregnancy and risk of neuropsychiatric events in offspring
    作者: Tsai, HJ;Yao, TC;Chang, YC
    貢獻者: Institute of Population Health Sciences
    摘要: Background: Leukotriene-receptor antagonists (LTRA) are a class of medications used for treating allergic airway diseases including asthma and allergic rhinitis. The U.S. Food and Drug Administration has monitored postmarketing data about the potential harm of neuropsychiatric events (NEs) with montelukast, the originator remedy of LTRA. However, evidence regarding the risk of NEs associated with LTRA in children have been conflicting. To the best of our knowledge, none studies report in utero effect of LTRA exposure on risk of NEs in offspring. Method: We used data from the entire National Health Insurance Research Database to identify pregnant women and their offspring during 2009 and 2019 in Taiwan. Exposure was defined as having any dispensed prescription for LTRA during pregnancy. Propensity score matching was applied to control for the systematic differences at baseline between LTRA users and non-users. Main outcomes are primary diagnoses of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or Tourette syndrome in offspring. Cox proportional hazards models were constructed to estimate the associations between prenatal LTRA exposure and NEs among offspring with covariate adjustment. Results: A total of 576,157 mother-offspring pairs (1995 LTRA exposed children and 574,162 non-exposed children) was identified in the original study population. After propensity score matching, 1988 LTRA exposed children and 19,880 non-exposed children were included in the subsequent analyses. No significant associations were found between prenatal LTRA exposure and ADHD, ASD and Tourette syndrome among offspring (adjusted hazard ratio (AHR) = 1.10; 95% confidence interval (CI): 0.85–1.42 for ADHD; AHR = 1.25; 95% CI: 0.82–1.89 for ASD; and AHR = 0.98; 95% CI: 0.49–1.93 for Tourette syndrome). In addition to overall LTRA exposure, duration of LTRA use (1–4 weeks vs. more than 4 weeks), and cumulative dose of LTRA (1–170 mg vs. more than 170 mg), separately, was not significantly associated with ADHD, ASD and Tourette syndrome among offspring. Conclusion: The use of LTRA during pregnancy does not pose significant risks of NEs in offspring. Clinicians prescribing LTRA to pregnant women with asthma or allergic rhinitis may be reassured by our findings of no increased risk of NEs, specifically ADHD, ASD and Tourette syndrome, in offspring.
    日期: 2023-12-28
    關聯: Allergy. 2023 Dec 28;78(Suppl. 112):312.
    Link to: http://dx.doi.org/10.1111/all.15925
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0105-4538&DestApp=IC2JCR
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