Occupational exposure to antineoplastic agents: self-reported miscarriages and stillbirths among nurses and pharmacists.
Occupational exposure to antineoplastic agents: self-reported miscarriages and stillbirths among nurses and pharmacists.
复制标题
抗肿瘤药物的职业暴露：护士和药剂师自我报告的流产和死产。
DOI：
10.1097/00043764-199908000-00004
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发表时间：
1999
影响因子：
3.2
通讯作者：
Steele,P
中科院分区：
文献类型：
--
作者：
Valanis,B;Vollmer,WM;Steele,P
怀孕前对卵子或精子的生殖细胞的损伤以及怀孕期间与胎儿的接触都会影响怀孕的结果。抗肿瘤药物具有致突变性和致畸性，因此接触这些药物对生殖的潜在影响引起了使用这些药物的工人的关注。本研究通过比较未接触抗肿瘤药物和孕妇或父亲在怀孕前或怀孕期间接触抗肿瘤药物的孕妇的自然流产和死产率，调查了与职业接触抗肿瘤药物相关的妊娠损失。共对2976名药学及护理人员7094例妊娠进行检查。在对孕期年龄、妊娠史、孕期吸烟、妊娠前自然流产或死产发生情况进行控制后，妊娠期间母亲接触或使用抗肿瘤药物与自然流产风险显著增加（优势比为1.5；95%可信区间为1.2 ~ 1.8）以及自然流产和死产合并风险显著增加相关(优势比为1.4；95%可信区间，1.2 - 1.7)，但不只是死产。在受辐射男性的妻子中，很少有死胎发生，无法进行分析。然而，对于自然流产和任何流产，风险增加的模式与女性相似，尽管比值比没有统计学意义。
Insult to the germ cells of an ovum or sperm prior to pregnancy as well as exposures to a fetus during pregnancy can affect the outcome of a pregnancy. Antineoplastic agents are mutagenic and teratogenic, so the potential effects of exposure on reproduction are of concern to the workers who handle them. This study investigates pregnancy loss associated with occupational exposures to antineoplastic drugs by comparing rates of spontaneous abortion and stillbirths for pregnancies without antineoplastic exposure and exposed pregnancies in which the pregnant woman or the father handled antineoplastic agents either before or during the pregnancy. A total of 7094 pregnancies of 2976 pharmacy and nursing staff were examined. After age during pregnancy, prior gravidity, maternal smoking during the pregnancy, and occurrence of a spontaneous abortion or stillbirth in a prior pregnancy were controlled for, exposure of the mother to or the handling of antineoplastic agents during the pregnancy was associated with a significantly increased risk of spontaneous abortion (odds ratio= 1.5; 95% confidence interval, 1.2 to 1.8) and combined risk of spontaneous abortion and stillbirth (odds ratio= 1.4; 95% confidence interval, 1.2 to 1.7) but not stillbirth alone. Among the wives of exposed men, too few stillbirths occurred to allow analysis. However, for spontaneous abortion and any loss, the patterns of increased risk were similar to those seen for women, although the odds ratios were not statistically significant.