Risk of stillbirth from medications, illnesses and medical procedures.
Risk of stillbirth from medications, illnesses and medical procedures.
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药物、疾病和医疗程序导致死产的风险。
DOI：
10.1046/j.1365-3016.1999.00196.x
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Beaumont,JJ
中科院分区：
文献类型：
--
作者：
Pastore,LM;Hertz-Picciotto,I;Beaumont,JJ
通过 1984 年加州 10 个县的分娩情况，研究了死产与怀孕期间 14 种医疗暴露之间的关联。病例（n= 332）为死产和婴儿出生后 24 小时内死亡。随机选择的活产婴儿作为对照 (n= 357)，并根据产妇年龄和县进行频率匹配。使用问卷和生命统计数据，进行逻辑回归和比例风险建模，并调整潜在的混杂因素。最常见的暴露是超声波（65% 的病例，58% 的对照）和对乙酰氨基酚（45% 的病例，54% 的对照）。在妊娠前 2 个月服用处方止痛药与先天性异常导致的死产密切相关（优势比 = 7.5，95% 置信区间 [CI] 2.3, 24.1）。妊娠早期和中期使用处方止痛药或偏头痛药物与所有死产呈正相关（比率 [RR] 范围 1.3-1.6）。生育药物与胎盘、脐带和胎膜并发症导致的死产和死产呈正相关（分别为 RR = 1.8，95% CI 0.8, 4.1；RR = 2.5，95% CI 0.9, 7.2）。没有发现阿司匹林、羊膜穿刺术、诊断性 X 射线或发烧之间的关联，这与之前的研究一致。该报告是针对死产具体原因和按妊娠时间窗口进行医疗暴露的少数研究之一。
Associations between stillbirth and 14 medical exposures during pregnancy were examined using deliveries in 1984 in 10 California counties. Cases (n= 332) were stillbirths and infant deaths within 24 h of birth. Randomly selected live births served as controls (n= 357) and were frequency matched by maternal age and county. Using questionnaire and vital statistics data, logistic regression and proportional hazards modelling were performed with adjustment for potential confounders. The most prevalent exposures were ultrasound (65% of cases, 58% of controls) and acetaminophen (45% of cases, 54% of controls). Prescription pain medication, when taken in the first 2 gestational months, was strongly associated with stillbirths due to congenital anomalies (odds ratio = 7.5, 95% confidence interval [CI] 2.3, 24.1). First and second trimester use of prescription pain or migraine medication was positively associated with all stillbirths (rate ratio [RR] range 1.3–1.6). Fertility drugs were positively associated with stillbirths in total and stillbirths due to complications of the placenta, cord and membranes (RR = 1.8, 95% CI 0.8, 4.1; and RR = 2.5, 95% CI 0.9, 7.2 respectively). No associations were found for aspirin, amniocentesis, diagnostic X‐rays or fever, consistent with previous studies. This report is among the few studies of specific causes of stillbirth and medical exposures by gestational time window.