Exposure to non-steroidal anti-inflammatory drugs during pregnancy and the risk of selected birth defects: a prospective cohort study.
Exposure to non-steroidal anti-inflammatory drugs during pregnancy and the risk of selected birth defects: a prospective cohort study.
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DOI：
10.1371/journal.pone.0022174
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Nordeng H
中科院分区：
文献类型：
--
作者：
van Gelder MM;Roeleveld N;Nordeng H
由于在怀孕期间使用非甾体抗炎药（NSAID）很常见，出生缺陷风险的小幅增加可能对公共卫生产生重大影响。关于NSAID致畸风险的人体研究结果不一致。因此，我们评估了产前暴露于处方和非处方NSAID后所选出生缺陷的风险。我们使用了1999年至2006年期间参加挪威母亲和儿童队列研究的69，929名妇女的数据。关于NSAID暴露的数据来自于在妊娠第17周左右完成的自填问卷。妊娠结局信息来自挪威医学出生登记处。多变量logistic回归分析仅包括基于拟定致畸机制和既往研究怀疑与NSAID暴露相关的出生缺陷。共有3，023名妇女在妊娠0-12周使用NSAID，64，074名妇女未报告妊娠早期使用NSAID。未观察到妊娠期间NSAID的总体暴露与单独或作为一组的所选出生缺陷之间存在关联（校正比值比0.7，95%置信区间0.4-1.1）。也未发现母亲使用特定类型NSAID与所选出生缺陷之间的相关性，尽管基于少量（2例暴露病例;粗比值比3.9，95%置信区间0.9-15.7），观察到间隔缺损和暴露于多种NSAID的风险增加。在妊娠前12周暴露于NSAID似乎与所选出生缺陷的风险增加无关。然而，由于个体出生缺陷类别中暴露于NSAID的婴儿数量较少，因此不能排除特定出生缺陷风险的增加。
Since use of non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy is common, small increases in the risk of birth defects may have significant implications for public health. Results of human studies on the teratogenic risks of NSAIDs are inconsistent. Therefore, we evaluated the risk of selected birth defects after prenatal exposure to prescribed and over-the-counter NSAIDs. We used data on 69,929 women enrolled in the Norwegian Mother and Child Cohort Study between 1999 and 2006. Data on NSAID exposure were available from a self-administered questionnaire completed around gestational week 17. Information on pregnancy outcome was obtained from the Medical Birth Registry of Norway. Only birth defects suspected to be associated with NSAID exposure based upon proposed teratogenic mechanisms and previous studies were included in the multivariable logistic regression analyses. A total of 3,023 women used NSAIDs in gestational weeks 0–12 and 64,074 women did not report NSAID use in early pregnancy. No associations were observed between overall exposure to NSAIDs during pregnancy and the selected birth defects separately or as a group (adjusted odds ratio 0.7, 95% confidence interval 0.4–1.1). Associations between maternal use of specific types of NSAIDs and the selected birth defects were not found either, although an increased risk was seen for septal defects and exposure to multiple NSAIDs based on small numbers (2 exposed cases; crude odds ratio 3.9, 95% confidence interval 0.9–15.7). Exposure to NSAIDs during the first 12 weeks of gestation does not seem to be associated with an increased risk of the selected birth defects. However, due to the small numbers of NSAID-exposed infants for the individual birth defect categories, increases in the risks of specific birth defects could not be excluded.
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影响因子：
4.3
作者：
Kubon, Christer;Sivertsen, Ase;Lie, Rolv Terje
通讯作者：
Lie, Rolv Terje
影响因子：
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作者：
Li, DK;Liu, LY;Douh, R
通讯作者：
Douh, R
影响因子：
5.4
作者：
Nohr, EA;Frydenberg, M;Olsen, J
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Olsen, J
影响因子：
3.3
作者：
Källén, BAJ;Olausson, PO
通讯作者：
Olausson, PO
影响因子：
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作者：
Olesen, C;Steffensen, FH;Sorensen, HT
通讯作者：
Sorensen, HT