Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects.
Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects.
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DOI：
10.1002/bdra.22865
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发表时间：
2012-01
影响因子：
--
通讯作者：
Rasmussen, Sonja A.
中科院分区：
文献类型：
--
作者：
Anderka, Marlene;Mitchell, Allen A.;Louik, Carol;Werler, Martha M.;Hernandez-Diaz, Sonia;Rasmussen, Sonja A.
关键词：
妊娠恶心和呕吐（NVP）发生在高达80%的孕妇中，但其与分娩结局的关系尚不清楚。几种药物用于治疗NVP;然而，关于其与出生缺陷可能相关的数据有限。使用来自国家出生缺陷预防研究（NBDPS）的数据，一项多中心基于人群的病例对照研究，我们研究了NVP或其治疗是否与NBDPS中最常见的非心脏缺陷（非综合征性唇裂伴或不伴腭裂（CL/P）、单纯腭裂（CP）、神经管缺陷（NTDs）和尿道下裂）相关，并与随机选择的非畸形活产婴儿进行了比较。在本研究纳入的4524例病例和5859例对照中，67.1%报告了妊娠早期NVP，其中15.4%报告使用至少一种NVP药物。妊娠期恶心和呕吐与CP或NTD无关，但观察到CL/P（aOR=0.87，0.77-0.98）和尿道下裂（OR=0.84，0.72-0.98）的风险适度降低。关于妊娠早期NVP的治疗，观察到以下调整后的相关性与风险增加：质子泵抑制剂与尿道下裂（aOR=4.36，1.21-15.81），激素与尿道下裂（aOR=2.87，1.03-7.97），昂丹司琼和CP（aOR=2.37，1.18-4.76），而抗酸剂与CL/P风险降低相关（aOR=0.58，0.38-0.89）。未观察到妊娠恶心和呕吐与出生缺陷风险增加相关，但与三种治疗（即质子泵抑制剂、类固醇和昂丹司琼）相关的可能风险可能是偶然发现，需要进一步研究。
Nausea and vomiting of pregnancy (NVP) occurs in up to 80% of pregnant women, yet its association with birth outcomes is not clear. Several medications are used for the treatment of NVP; however, data are limited on their possible associations with birth defects. Using data from the National Birth Defects Prevention Study (NBDPS), a multi-site population-based case-control study, we examined whether NVP or its treatment was associated with the most common non-cardiac defects in the NBDPS (non-syndromic cleft lip with or without cleft palate (CL/P), cleft palate alone (CP), neural tube defects (NTDs), and hypospadias) compared to randomly-selected non-malformed live births. Among the 4524 cases and 5859 controls included in this study, 67.1% reported first trimester NVP, and 15.4% of them reported using at least one agent for NVP. Nausea and vomiting of pregnancy was not associated with CP or NTDs, but modest risk reductions were observed for CL/P (aOR=0.87, 0.77–0.98), and hypospadias (OR=0.84, 0.72–0.98). In regards to treatments for NVP in the first trimester, the following adjusted associations were observed with an increased risk: proton pump inhibitors and hypospadias (aOR=4.36, 1.21–15.81), steroids and hypospadias (aOR=2.87, 1.03–7.97), and ondansetron and CP (aOR=2.37, 1.18–4.76), while antacids were associated with a reduced risk for CL/P (aOR=0.58, 0.38–0.89). Nausea and vomiting of pregnancy was not observed to be associated with an increased risk of birth defects, but possible risks related to three treatments (i.e. proton pump inhibitors, steroids and ondansetron), which could be chance findings, warrant further investigation.
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影响因子：
2
作者：
Genisca, Alicia E.;Frias, Jaime L.;Broussard, Cheryl S.;Honein, Margaret A.;Lammer, Edward J.;Moore, Cynthia A.;Shaw, Gary M.;Murray, Jeffrey C.;Yang, Wei;Rasmussen, Sonja A.
通讯作者：
Rasmussen, Sonja A.
DOI：
10.1016/s0301-2115(00)00388-2
发表时间：
2001-05-01
期刊：
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY
影响因子：
--
作者：
Källén, BAJ
通讯作者：
Källén, BAJ
DOI：
10.1111/j.1471-0528.2004.00236.x
发表时间：
2004-09-01
影响因子：
5.8
作者：
Einarson, A;Maltepe, C;Koren, G
通讯作者：
Koren, G
影响因子：
5.1
作者：
Carmichael, Suzan L.;Ma, Chen;Shaw, Gary M.
通讯作者：
Shaw, Gary M.
DOI：
10.1111/j.1471-0528.1998.tb10233.x
发表时间：
1998-08-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
Kallen, B
通讯作者：
Kallen, B