Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis.
Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis.
复制标题
DOI：
10.1186/s13023-018-0789-3
复制
发表时间：
2018-05-10
影响因子：
3.7
通讯作者：
Jenetzky E
中科院分区：
文献类型：
--
作者：
Zwink N;Jenetzky E
肛门直肠畸形（ARM）的起源被认为是多因素的。一些遗传和非遗传风险因素在文献中进行了讨论。然而，尚未系统地回顾母亲围产期使用药物作为可能的风险因素。通过PubMed、ISI Web of Knowledge和Scopus数据库中的系统检索，对1977年至2017年4月期间发表的研究进行了综述。此外，还审查了相关和相互参照的出版物。合并or值（95%可信区间），以量化母亲围受孕期使用叶酸、多种维生素、抗哮喘药物（单独使用任何抗哮喘药物、吸入性皮质类固醇和沙丁胺醇）、甲状腺激素补充剂、精神病药物（单独用于抗抑郁药、任何选择性5-羟色胺再摄取抑制剂[SSRI]、舍曲林、西酞普兰、氟西汀、帕罗西汀，催眠药和苯二氮卓类药物）和阿司匹林与ARM的荟萃分析。37项研究报道了母亲围受孕期药物摄入与出生时患有ARM的婴儿之间的关联。这些研究在美国（n = 14）、瑞典（n = 6）、匈牙利（n = 5）、德国（n = 3）、荷兰（n = 3）、丹麦（n = 2）、法国（n = 2）、挪威（n = 1）和英国（n = 1）进行。然而，这些研究中只有少数报告了相同的风险因素。研究在病例数、医疗药物使用期间摄入、对照选择和协变量调整方面具有异质性。观察到任何抗哮喘药物、催眠药和苯二氮卓类药物的风险持续增加，但叶酸、多种维生素、吸入性皮质类固醇、沙丁胺醇、甲状腺激素补充剂、抗抑郁药、任何SSRI、舍曲林、西酞普兰、氟西汀、帕罗西汀和阿司匹林的风险未持续增加。在荟萃分析中，任何抗哮喘药物、催眠药和苯二氮卓类药物的合并比值比（95%置信区间）分别为1.64（1.22-2.21）和2.43（1.03-5.73）。流行病学研究中关于母亲在怀孕前和怀孕期间使用药物是ARM风险因素的证据仍然非常有限。然而，少数现有的研究表明任何抗哮喘药物，催眠药和苯二氮卓类药物与风险增加有关。此外，理想情况下，需要进行大规模多中心和基于登记的研究，以澄清母体药物摄入对ARM发展的作用。
Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. Studies published between 1977 and April 2017 were reviewed through systematic search in PubMed, ISI Web of Knowledge and Scopus databases. Furthermore, related and cross-referencing publications were reviewed. Pooled odds ratios (95% confidence intervals) were determined to quantify associations of maternal periconceptional use of folic acid, multivitamins, anti-asthma medication (separated in any anti-asthma medication, inhaled corticosteroids and salbutamol), thyroid hormone supplements, psychiatric drugs (separated in antidepressants, any selective serotonin reuptake inhibitors [SSRI], sertraline, citalopram, fluoxetine, paroxetine, hypnotics and benzodiazepine) and aspirin with ARM using meta-analyses. Thirty-seven studies that reported on the association between maternal periconceptional drug intake and infants born with ARM were included in this review. These were conducted in the United States of America (n = 14), Sweden (n = 6), Hungary (n = 5), Germany (n = 3), the Netherlands (n = 3), Denmark (n = 2), France (n = 2), Norway (n = 1) and the UK (n = 1). However, only few of these studies reported on the same risk factors. Studies were heterogeneous with respect to case numbers, period ingestion of medical drug use, control selection and adjustment for covariates. Consistently increased risks were observed for any anti-asthma medication, and hypnotics and benzodiazepine, but not for folic acid, multivitamins, inhaled corticosteroids, salbutamol, thyroid hormone supplements, antidepressants, any SSRI, sertraline, citalopram, fluoxetine, paroxetine and aspirin. In meta-analyses, pooled odds ratios (95% confidence intervals) for any anti-asthma medication, and hypnotics and benzodiazepine were 1.64 (1.22–2.21), and 2.43 (1.03–5.73), respectively. Evidence on maternal drug use before conception and during pregnancy as risk factor for ARM from epidemiological studies is still very limited. Nevertheless, the few available studies indicate any anti-asthma medication, and hypnotics and benzodiazepine to be associated with increased risks. Further, ideally large-scale multicenter and register-based studies are needed to clarify the role of maternal drug intake for the development of ARM.
登录
查看更多内容
影响因子：
9.8
作者：
Czeizel, AE;Rockenbauer, M;Olsen, J
通讯作者：
Olsen, J
DOI：
10.1002/ajmg.1532
发表时间：
2001-10-15
期刊：
AMERICAN JOURNAL OF MEDICAL GENETICS
影响因子：
--
作者：
Cuschieri, A
通讯作者：
Cuschieri, A
影响因子：
9.8
作者：
Cooper, William O.;Willy, Mary E.;Ray, Wayne A.
通讯作者：
Ray, Wayne A.
影响因子：
4.3
作者：
Acs, Nandor;Banhidy, Ferenc;Czeizel, Andrew E.
通讯作者：
Czeizel, Andrew E.
影响因子：
2.4
作者：
Bitoh, Y;Shimotake, T;Iwai, N
通讯作者：
Iwai, N