抗狼疮药羟氯喹、硫唑嘌呤和……
抗狼疮药羟氯喹、硫唑嘌呤和甲氨蝶呤可安全用于哺乳期
作者：Noviani M，et al.
翻译：北医三院张警丰
摘要：背景：众所周知母乳喂养有利于母亲及婴儿，约半数母亲采取母乳喂养，但是系统性红斑狼疮（SLE）患者应该如何采取母乳喂养却没有研究。本研究的目的是分析狼疮患者母乳喂养率及影响母乳喂养的相关因素。此外，我们重新探讨了哺乳期狼疮用药的安全性数据。方法：本研究为前瞻性登记研究，纳入患者符合2012年SLICC狼疮分类标准，有活产，产后哺乳情况可获得的患者。收集数据包括医生评估的狼疮活动度及用药情况，孕期母乳喂养意向以及产后母乳喂养实际情况。婴儿母乳喂养期间的药物安全性通过LactMed综合分析获得，LactMed为哺乳期用药的国际性数据库。结果：本研究共纳入84例狼疮女性共51例分娩。半数狼疮患者（n=25,49%）选择母乳喂养。母乳喂养率并未受到社会经济因素的显著影响。相反，产后狼疮低疾病活动度、足月分娩和产前即有母乳喂养计划与狼疮患者的母乳喂养显著相关。回顾大量更新的数据后发现，大多数狼疮药物仅有极微量进入乳汁，大部分可以安全用于哺乳期。结论：半数狼疮患者采用母乳喂养，大多数患者意向采用母乳喂养。羟氯喹、硫唑嘌呤、甲氨蝶呤和强的松仅极少量进入乳汁，可以考虑于哺乳期继续使用。
附原文：INTRODUCTION:Breastfeeding is known to improve the well-being of a mother and her infant, and about half of all new mothers breastfeed, but it is unknown how breastfeeding is pursued in systemic lupus erythematosus (SLE; lupus) patients. We sought to determine the rate of breastfeeding and the factors influencing this among women with lupus. In addition, we reassessed the current safety data in lactation of lupus medications. METHODS:Data were collected from lupus patients enrolled in a prospective registry who fulfilled the 2012 SLICC criteria, had a live birth, and for whom postpartum breastfeeding status was known. Data included physician assessments of lupus activity and medications, breastfeed ingintentions during pregnancy and practice following pregnancy. The safety of medications in breastfed infants was assessed through a comprehensive review of LactMed, a national database about medications in lactation. RESULTS:A total of 51 pregnancies in 84 women with lupus were included in the study. Half of the lupus patients (n = 25, 49%) chose to breastfeed. The rate of breastfeeding was not significantly affected by socioeconomic factors. In contrast, low postpartum lupus activity, term delivery, and a plan to breastfeed early in pregnancy were significantly associated with breastfeeding in lupus patients. In reviewing the most up-to-date data, the majority of lupus medications appear to have very minimal transfer into breast milk and are likely compatible with breastfeeding. CONCLUSION:Half of women with lupus breastfed and most desire to breastfeed. Hydroxychloroquine, azathioprine, methotrexate, and prednisone have very limited transfer into breast milk and may be continued while breastfeeding.
引自：Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016 Aug;25(9):973-9.
作者：Noviani M，et al.
翻译：北医三院张警丰
摘要：背景：众所周知母乳喂养有利于母亲及婴儿，约半数母亲采取母乳喂养，但是系统性红斑狼疮（SLE）患者应该如何采取母乳喂养却没有研究。本研究的目的是分析狼疮患者母乳喂养率及影响母乳喂养的相关因素。此外，我们重新探讨了哺乳期狼疮用药的安全性数据。方法：本研究为前瞻性登记研究，纳入患者符合2012年SLICC狼疮分类标准，有活产，产后哺乳情况可获得的患者。收集数据包括医生评估的狼疮活动度及用药情况，孕期母乳喂养意向以及产后母乳喂养实际情况。婴儿母乳喂养期间的药物安全性通过LactMed综合分析获得，LactMed为哺乳期用药的国际性数据库。结果：本研究共纳入84例狼疮女性共51例分娩。半数狼疮患者（n=25,49%）选择母乳喂养。母乳喂养率并未受到社会经济因素的显著影响。相反，产后狼疮低疾病活动度、足月分娩和产前即有母乳喂养计划与狼疮患者的母乳喂养显著相关。回顾大量更新的数据后发现，大多数狼疮药物仅有极微量进入乳汁，大部分可以安全用于哺乳期。结论：半数狼疮患者采用母乳喂养，大多数患者意向采用母乳喂养。羟氯喹、硫唑嘌呤、甲氨蝶呤和强的松仅极少量进入乳汁，可以考虑于哺乳期继续使用。
附原文：INTRODUCTION:Breastfeeding is known to improve the well-being of a mother and her infant, and about half of all new mothers breastfeed, but it is unknown how breastfeeding is pursued in systemic lupus erythematosus (SLE; lupus) patients. We sought to determine the rate of breastfeeding and the factors influencing this among women with lupus. In addition, we reassessed the current safety data in lactation of lupus medications. METHODS:Data were collected from lupus patients enrolled in a prospective registry who fulfilled the 2012 SLICC criteria, had a live birth, and for whom postpartum breastfeeding status was known. Data included physician assessments of lupus activity and medications, breastfeed ingintentions during pregnancy and practice following pregnancy. The safety of medications in breastfed infants was assessed through a comprehensive review of LactMed, a national database about medications in lactation. RESULTS:A total of 51 pregnancies in 84 women with lupus were included in the study. Half of the lupus patients (n = 25, 49%) chose to breastfeed. The rate of breastfeeding was not significantly affected by socioeconomic factors. In contrast, low postpartum lupus activity, term delivery, and a plan to breastfeed early in pregnancy were significantly associated with breastfeeding in lupus patients. In reviewing the most up-to-date data, the majority of lupus medications appear to have very minimal transfer into breast milk and are likely compatible with breastfeeding. CONCLUSION:Half of women with lupus breastfed and most desire to breastfeed. Hydroxychloroquine, azathioprine, methotrexate, and prednisone have very limited transfer into breast milk and may be continued while breastfeeding.
引自：Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016 Aug;25(9):973-9.
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