Maternal surgery and anesthesia during pregnancy and risk of birth defects in the National Birth Defects Prevention Study, 1997-2011.
Maternal surgery and anesthesia during pregnancy and risk of birth defects in the National Birth Defects Prevention Study, 1997-2011.
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DOI：
10.1002/bdr2.1616
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发表时间：
2020-01-15
影响因子：
2.1
通讯作者：
National Birth Defects Prevention Study
中科院分区：
文献类型：
--
作者：
Fisher SC;Siag K;Howley MM;Van Zutphen AR;Reefhuis J;Browne ML;National Birth Defects Prevention Study
最近很少有关于母体麻醉暴露致畸性的研究。我们使用国家出生缺陷预防研究数据来描述妊娠期间进行的外科手术，并估计与围受孕期麻醉暴露相关的出生缺陷风险。我们使用逻辑回归分析来评估围受孕期全身麻醉和局部麻醉与特定出生缺陷之间的关系。我们计算了25例出生缺陷与至少5例暴露病例（11，501例对照，24，337例病例）的比值比和95%置信区间，调整了母亲的种族/民族，年龄，体重指数，X射线，CT或放射性核素扫描的围受孕期暴露以及研究地点。最常报告的手术是牙科、皮肤科和宫颈环扎术，与妊娠时间无关。总体而言，226例病例和73例对照组女性报告了围产期全身麻醉; 230例病例和89例对照组女性报告了围产期局部麻醉。报告全身麻醉或局部麻醉的女性中，非西班牙裔白色比例不成比例，并且更有可能报告围受孕期阿片类药物使用和至少一次围受孕期X线/CT/放射性核素扫描。报告全身麻醉的女性也更可能报告围产期损伤。我们没有观察到任何类型的麻醉暴露和研究的出生缺陷之间的显着关联。优势比一般接近零和不精确。我们的研究人群报告了妊娠期间广泛的外科手术，需要全身麻醉和局部麻醉。我们的研究结果表明，围产期麻醉与本研究中评估的出生缺陷没有很强的相关性。
There is little recent research on the teratogenicity of maternal anesthesia exposure. We used National Birth Defects Prevention Study data to describe surgical procedures conducted during pregnancy and to estimate the risk of birth defects associated with periconceptional anesthesia exposure. We used logistic regression to assess associations between general and local anesthesia for surgery during the periconceptional period and specific birth defects. We calculated odds ratios and 95% confidence intervals for 25 birth defects with at least five exposed cases (11,501 controls, 24,337 cases), adjusted for maternal race/ethnicity, age, body mass index, periconceptional exposure to X-ray, CT, or radionuclide scans, and study site. The most commonly reported procedures were dental, dermatologic, and cervical cerclage procedures, regardless of gestational timing. Overall, 226 case and 73 control women reported periconceptional general anesthesia; 230 case and 89 control women reported periconceptional local anesthesia. Women who reported general or local anesthesia were disproportionately non-Hispanic white and were more likely to report periconceptional opioid use and at least one periconceptional X-ray/CT/radionuclide scan. Women who reported general anesthesia were also more likely to report periconceptional injury. We did not observe any significant associations between either type of anesthesia exposure and the birth defects studied. Odds ratios were generally close to null and imprecise. Our study population reported a wide range of surgical procedures during pregnancy, requiring both general and local anesthesia. Our findings suggest that periconceptional anesthesia is not strongly associated with the birth defects assessed in this study.
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DOI：
10.1002/tera.1420310114
发表时间：
1985-01-01
期刊：
TERATOLOGY
影响因子：
--
作者：
LEE, H;NAGELE, RG
通讯作者：
NAGELE, RG
影响因子：
8.8
作者：
通讯作者：
--
影响因子：
6.2
作者：
Kuczkowski, KM
通讯作者：
Kuczkowski, KM
影响因子：
8.8
作者：
DUNCAN, PG;POPE, WDB;GREER, N
通讯作者：
GREER, N
DOI：
10.1016/0002-9378(89)90659-5
发表时间：
1989-11-01
影响因子：
9.8
作者：
MAZZE, RI;KALLEN, B
通讯作者：
KALLEN, B