Histologic Chorioamnionitis, Fetal Involvement, and Antenatal Steroids: Effects on Neonatal Outcome in Preterm Infants
Histologic Chorioamnionitis, Fetal Involvement, and Antenatal Steroids: Effects on Neonatal Outcome in Preterm Infants
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DOI：
10.1097/01.aoa.0000389603.63510.ef
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发表时间：
2010-12
期刊：
影响因子：
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通讯作者：
J. Been;I. Rours;R. Kornelisse;V. L. Passos;B. Kramer;T. A. Schneider;R. R. D. Krijger-R.;L. Zimmermann
中科院分区：
文献类型：
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作者：
J. Been;I. Rours;R. Kornelisse;V. L. Passos;B. Kramer;T. A. Schneider;R. R. D. Krijger-R.;L. Zimmermann
最常见的是咪康唑、特康唑和克霉唑。 29 名对照者和 55 名病例母亲使用了未知的抗真菌药物。左心发育不全综合征的风险在统计学上显着增加[比值比 (OR)，2.30； 95% 置信区间 (CI)，1.04-5.06]，但未发现其他心血管缺陷的风险增加。膈疝风险无统计学意义（OR，1.88；95% CI，0.93-3.78）。暴露女性中其他缺陷的 OR 为：肛门直肠闭锁（1.42；95% CI，0.66-3.06）、脊柱裂（1.40；CI，0.74-2.66）、神经管缺陷（1.25；95% CI，0.72-2.15）、唇裂（1.24；CI，0.78-1.99）、圆锥干心脏缺陷（1.20；95% CI，0.692.10）、法洛四联症（1.11；95% CI，0.45-2.77）；颅缝早闭（1.02；95% CI，0.49-2.13）和右心室流出道梗阻（1.00；95% CI，0.50-1.99）。其他 OR <1.0 的患者为左心室流出道梗阻；尿道下裂;心室、膜周室和房间隔缺损；和腹裂。这些结果表明，妊娠早期使用抗真菌药物不会增加大多数出生缺陷的风险，尽管作者认为应该进行更多研究来检验与左心发育不良综合征的关联。克霉唑可以降低早产风险，在警告怀孕期间使用克霉唑之前，需要进行研究证实其与出生缺陷的相关性。
most commonly with miconazole, terconazole, and clotrimazole. Unknown antifungal medications were used by 29 controls and 55 case mothers. A statistically significant increased risk for hypoplastic left heart syndrome [odds ratio (OR), 2.30; 95% confidence interval (CI), 1.04-5.06] was seen, but no increased risk for other cardiovascular defects was found. The risk for diaphragmatic hernia was not statistically significant (OR, 1.88; 95% CI, 0.93-3.78). ORs for other defects in exposed women were: anorectal atresia (1.42; 95% CI, 0.66-3.06), spina bifida (1.40; CI, 0.74-2.66), neural tube defects (1.25; 95% CI, 0.72-2.15), cleft lip (1.24; CI, 0.78-1.99), conotruncal heart defects (1.20; 95%CI, 0.692.10), tetralogy of Fallot (1.11; 95% CI, 0.45-2.77); craniosynostosis (1.02; 95% CI, 0.49-2.13) and right ventricular outflow tract obstruction (1.00; 95% CI, 0.50-1.99). Others with ORs of <1.0 were left ventricular outflow tract obstruction; hypospadias; ventricular, perimembranous ventricular, and atrial septal defects; and gastroschisis. These results suggest that the first-trimester use of antifungal drugs does not increase risk formost birth defects, although the authors felt that more studies should examine the association with hypoplastic left heart syndrome. Clotrimazole may reduce the risk of preterm birth and studies that confirm an association with birth defects is needed before cautioning against its use in pregnancy.