Maternal exposure to prescription and non prescription pharmaceuticals or drugs of abuse and risk of craniosynostosis
Maternal exposure to prescription and non prescription pharmaceuticals or drugs of abuse and risk of craniosynostosis
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DOI：
10.1093/ije/27.1.64
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发表时间：
1998-02-01
影响因子：
7.7
通讯作者：
Mangione, EJ
中科院分区：
文献类型：
--
作者：
Gardner, JS;Guyard-Boileau, B;Mangione, EJ
背景：在科罗拉多州的一项儿童病例对照研究中，研究了妇女在产前和围产期所报告的药物暴露与婴儿颅缝闭合的关系。方法对病例和对照儿童的母亲进行标准化的电话访谈以及产科和新生儿的病历回顾。访谈包括关于处方药和非处方药的使用、营养补充剂、娱乐和滥用药物的问题。从母亲的产科记录中提取产前服用药物的信息。结果没有统计学意义上的颅缝早闭与产前接触海因、丙戊酸或可卡因相关的风险比。四名病例儿童和一名对照儿童的母亲报告了具体接触维甲酸的情况。在接触低氧剂、交感神经或副交感神经溶解药物或含金属药物的儿童中，任何缝合类型的优势比(OR)没有统计学意义上的显著增加。与对照组相比，暴露于亚硝酸类药物氯苯那敏、氯氮卓酮和呋喃妥因的矢状缝/板状缝融合儿童的OR值为1.87(双侧95%可信区间下限：1.08)。结论某些亚硝酸类药物可能与婴儿矢状缝/板状缝融合的危险性增加有关。提示了缺血/再灌注损伤的可能机制。
Background The pre-and peri-natal drug exposures reported by women participating in a case-control study of children in Colorado were examined for association with infant craniosynostosis.Methods Mothers of case and control children underwent a standardized telephone interview and obstetric and newborn medical record review. The interview included questions on the use of prescription and non-prescription drugs, nutritional supplements, recreational and drugs of abuse. The mother's obstetric record was abstracted for information about pharmacologic agents taken before and during the antepartum period.Reults There were no statistically significant risk ratios associating craniosynostosis with prenatal exposure to hydantoin, valproic acid, or cocaine. Mothers of four case children and one control child reported specific exposure to retinoic acid. There were no statisically significant increases in the odds ratio (OR) for any suture type among children exposed to hypoxigenic agents, sympathomimetic or parasympatholytic agents, or metal-containing agents. The OR was 1.87 (lower bound of the two-sided 95% test-based confidence interval (CI): 1.08) among children with sagittal/lambdoid suture synostosis who were exposed to nitrosatable drugs chlorpheniramine, chlordiazepoxide, and nitrofurantoin compared to controls.Conclusions Certain nitrosatable drugs may be associated with increased risk of infant sagittal/lambdoid craniosynostosis. A possible mechanism related to ischaemia/reperfusion injury is suggested.