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Grippe saisonni?re : les m?dicaments ne seraient pas nocifs pour les femmes enceintes

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  • Grippe saisonni?re : les m?dicaments ne seraient pas nocifs pour les femmes enceintes

    Grippe saisonni?re : les m?dicaments ne seraient pas nocifs pour les femmes enceintes


    Le Tamiflu, Le Relenza et la Flumadine, trois m?dicaments oraux utilis?s pour soigner la grippe saisonni?re, ne seraient pas dangereux pour la sant? des femmes enceintes et de leur b?b?, selon une ?tude men?e par des chercheurs de l'University of Texas Southwestern Medical Center, publi?e dans l'?dition du mois d'avril de la revue Obstetrics and Gynecology. Les chercheurs n'ont not? aucune diff?rence significative entre la sant? des m?res soign?es contre la grippe et les autres.

    En ?tudiant les dossiers m?dicaux de plus de 82.000 femmes enceintes, dont 239 atteintes de grippe saisonni?re et soign?es avec l'un des trois m?dicaments, les chercheurs ont conclu que les traitements utilis?s n'avaient aucune influence sur la sant? des m?res et de leur enfant.

    Ainsi, les femmes enceintes gripp?es n'ont pas ?t? plus touch?es par un accouchement pr?matur?, un diab?te gestationnel, une rupture pr?matur?e de la membrane ou de la fi?vre que les femmes "saines" n'ayant pas eu recours ? un traitement.

    M?me chose pour les nourrissons. Les chercheurs n'ont constat? aucune diff?rence de poids, de convulsions, ou de probl?mes de sant? graves ? la naissance des b?b?s dont les m?res ont re?u un traitement contre la grippe saisonni?re.

    N?anmoins, les chercheurs soulignent le fait que seulement 13% des femmes gripp?es ont b?n?fici? d'un traitement au cours du premier trimestre de grossesse, un moment cl? pour le d?veloppement du foetus.

    "Dans l'ensemble, cette ?tude fournit des donn?es importantes sur la s?curit? des m?dicaments prescrits aux femmes enceintes afin de guider les professionnels de la sant? et les patients dans le traitement de la grippe pendant la grossesse", explique le Dr. Greer, principal auteur de l'?tude.

    Study Finds Drugs Used for Treatment of Influenza in Pregnancy Appear to be Safe



    04/27/2010
    Tamiflu and two other drugs used to treat influenza appear safe for pregnant women and their babies, researchers at UT Southwestern Medical Center have found in a retrospective study of 239 cases of women who received the medications during pregnancy.
    The study provides "reassuring safety data about commonly used medications," the researchers concluded in their study, which appears in the April issue of Obstetrics and Gynecology.
    "A woman has to balance the benefits and potential risks of any medication taken during pregnancy. But with influenza, the added risks of complications from the disease in pregnancy need to be considered," said Dr. George Wendel, professor of obstetrics and gynecology at UT Southwestern and senior author of the study. "This is the first large study that systematically looked at the safety of all these drugs in pregnancy," he said.
    Researchers analyzed the medical records of 82,336 women who gave birth at Parkland Memorial Hospital from 2003 to 2008, a period that spanned five flu seasons. The investigators compared two groups of pregnant women: women without flu and women with flu who had received one of three oral medications marketed under the brands Tamiflu, Relenza and Flumadine. Of the women studied, 239 had flu and had been treated with one of the three medications.
    The study showed no difference in the mothers' rates of preeclampsia, preterm birth, gestational diabetes, premature membrane rupture, fever during labor or prolonged hospital stay.
    After birth, there was no difference in birth weight, need for intensive care, seizures or jaundice among the babies. There also was no significant difference in stillbirths or major or minor malformations that could be attributed to the medications, the study showed.
    The only significant difference involved a bowel condition, necrotizing enterocolitis, often associated with prematurity. Two premature babies in the treatment group were born with this condition. Each of the mothers, however, received a different anti-flu drug, so the prematurity may have been the major common factor, said Dr. Laura Greer, assistant instructor of obstetrics and gynecology and lead author of the paper.
    One limitation of study was that only 13 percent of the women with flu were treated during the first trimester, a critical time in fetal development. "Overall, this study provides important safety data to guide clinicians and patients in treating influenza in pregnancy," Dr. Greer said.
    The data collection stopped a year before the pandemic H1N1 flu strain, or swine flu, became widespread. Tamiflu was used in 2009 to treat pandemic H1N1 infection, a type of influenza A; it is also effective in treating seasonal influenza A and B infection. The other two medications were more commonly used in earlier influenza seasons.
    Other UT Southwestern obstetrics and gynecology researchers involved in the study were Dr. Jeanne Sheffield, associate professor; Dr. Vanessa Rogers, assistant professor; Dr. Scott Roberts, professor; and Dr. Donald McIntire, professor.



    Obstetrics & Gynecology:
    April 2010 - Volume 115 - Issue 4 - pp 711-716
    doi: 10.1097/AOG.0b013e3181d44752
    Original Research

    Maternal and Neonatal Outcomes After Antepartum Treatment of Influenza With Antiviral Medications

    Greer, Laura G. MD; Sheffield, Jeanne S. MD; Rogers, Vanessa L. MD; Roberts, Scott W. MD, MS; McIntire, Donald D. PhD; Wendel, George D. Jr MD





    Abstract



    OBJECTIVE: To review the maternal and neonatal outcomes after antepartum exposure to M2 ion channel inhibitors or oseltamivir to provide some guidance on the risk, if any, of antiviral medication during pregnancy.
    METHODS: This was a retrospective cohort study examining maternal and neonatal outcomes after antepartum exposure to antiviral therapy for influenza. We evaluated maternal characteristics, pregnancy outcomes, and fetal outcomes and compared them with our overall obstetric population.
    RESULTS: Exposure to antiviral therapies (M2 ion channel inhibitors [n=104] compared with oseltamivir [n=135] compared with the control group [n=82,097]) during pregnancy was not associated with increased rates of preterm birth (7% compared with 10% compared with 6%, P=.190), premature rupture of membranes (23% compared with 16% compared with 22%, P=.154), gestational diabetes (4% compared with 8% compared with 6%, P=.388), or preeclampsia (6% compared with 1% compared with 4%, P=.209). Exposure was not associated with increased duration of hospital stay for mother or neonate. There were no differences in the incidence of minor malformations (19% compared with 15% compared with 22%, P=.101). Liveborn singletons without major malformations did not have differences in fetal weight (3,238?586 g compared with 3,281?642 g compared with 3,336?571 g, P=.186), need for intubation (2% compared with 0.8% compared with 1%, P=.552), intensive care nursery admission (3% compared with 3% compared with 2%, P=.418), or hyperbilirubinemia (12% compared with 9% compared with 8%, P=.282). Liveborn singletons had no grade 3 or 4 intraventricular hemorrhages, seizures, or neonatal deaths. Two preterm neonates exposed to different classes of medications had necrotizing enterocolitis (1.0% compared with 0.8% compared with 0.02%, P<.001).
    CONCLUSION: We found no evidence of an association between antepartum antiviral exposure and adverse outcomes.
    LEVEL OF EVIDENCE: II
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