Maternal treatment with opioid analgesics and risk for birth defects
Maternal treatment with opioid analgesics and risk for birth defects
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DOI：
10.1016/j.ajog.2010.12.039
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发表时间：
2011-04-01
影响因子：
9.8
通讯作者：
Honein, Margaret A.
中科院分区：
文献类型：
--
作者：
Broussard, Cheryl S.;Rasmussen, Sonja A.;Honein, Margaret A.
目的：我们研究孕妇在孕前1个月至妊娠早期服用阿片类药物是否与出生缺陷有关。研究设计：国家出生缺陷预防研究（1997 - 2005）是一项正在进行的基于人群的病例对照研究。我们估计了至少200例婴儿或至少4例暴露婴儿的出生缺陷类别的调整优势比（ORs）和95%置信区间（CIS）。结果：17449例母亲中有2.6%报告了阿片类药物的治疗性使用，6701例对照母亲中有2.0%报告了阿片类药物的治疗性使用。治疗与婴儿间室间隔缺损（OR, 2.7; 95% CI, 1.1-6.3）、房室间隔缺损（OR, 2.0; 95% CI, 1.2-3.6）、左心发育不全综合征（OR, 2.4; 95% CI, 1.4-4.1）、脊柱裂（OR, 2.0; 95% CI, 1.3-3.2）或胃裂（OR, 1.8; 95% CI, 1.1-2.9）有统计学显著相关。结论：与先前的一些研究一致，我们的研究显示了妊娠早期母体阿片类镇痛治疗与某些出生缺陷之间的关联。在怀孕期间作出治疗决定的妇女及其医生应考虑这一信息。
OBJECTIVE: We examined whether maternal opioid treatment between 1 month before pregnancy and the first trimester was associated with birth defects.STUDY DESIGN: The National Birth Defects Prevention Study (1997 through 2005) is an ongoing population-based case-control study. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIS) for birth defects categories with at least 200 case infants or at least 4 exposed case infants.RESULTS: Therapeutic opioid use was reported by 2.6% of 17,449 case mothers and 2.0% of 6701 control mothers. Treatment was statistically significantly associated with conoventricular septal defects (OR, 2.7; 95% CI, 1.1-6.3), atrioventricular septal defects (OR, 2.0; 95% CI, 1.2-3.6), hypoplastic left heart syndrome (OR, 2.4; 95% CI, 1.4-4.1), spina bifida (OR, 2.0; 95% CI, 1.3-3.2), or gastroschisis (OR, 1.8; 95% CI, 1.1-2.9) in infants.CONCLUSION: Consistent with some previous investigations, our study shows an association between early pregnancy maternal opioid analgesic treatment and certain birth defects. This information should be considered by women and their physicians who are making treatment decisions during pregnancy.