Senna treatment in pregnant women and congenital abnormalities in their offspring-A population-based case-control study
Senna treatment in pregnant women and congenital abnormalities in their offspring-A population-based case-control study
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DOI：
10.1016/j.reprotox.2009.02.005
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发表时间：
2009-07-01
影响因子：
3.3
通讯作者：
Czeizel, Andrew E.
中科院分区：
文献类型：
--
作者：
Acs, Nandor;Banhidy, Ferenc;Czeizel, Andrew E.
目前，常用泻药番泻叶的致畸作用尚未在病例对照流行病学研究中得到证实。本研究的目的是在匈牙利先天性畸形病例对照监测系统的大数据集中，比较先天性畸形（CA）病例和无CA的配对对照。在22，843例CA病例中，2.2%的母亲接受番泻叶治疗，而在38,151名对照新生儿中，（2.5%）的婴儿是由接受番泻叶治疗的母亲所生（调整后的OR，95%CI：1.0，0.9-1.1），834例畸形对照组中，26例（3.1%）母亲服用番泻叶（OR，95%CI：0.7，0.5 ~ 1.1）。番泻叶的剂量范围在10毫克和30毫克之间，但大多数孕妇每天使用20毫克。番泻叶治疗的母亲表现出孕妇便秘的特征（绒山羊的便秘比例较大）。与500名匹配的对照组相比，260名母亲在妊娠第二个月和/或第三个月（即大多数主要CA的关键时期）接受番泻叶治疗后，23个不同CA组的风险并没有更高。与未接受番泻叶治疗的母亲所生的婴儿相比，接受番泻叶治疗的母亲所生的无CA新生儿的分娩时胎龄稍长（0.2周），早产率较低（6.6%对9.2%）。总之，番泻叶治疗与便秘孕妇后代CA的高风险无关。(C)2009爱思唯尔公司All rights reserved.
Previously, the possible teratogenic effect of frequently used laxative drug, senna has not been checked in case-control epidemiological study. objective of the study was the comparison of cases with congenital abnormalities (CAs) and their matched controls without CAs in the population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities. Of 22,843 cases with CA, 506 (2.2%) had mothers with senna treatment, while of 38,151 control newborn infants without CA, 937 (2.5%) were born to mothers with senna treatment (adjusted OR with 95% CI: 1.0, 0.9-1.1), and of 834 malformed controls with Down syndrome, 26 (3.1%) had mothers with the use of senna (OR with 95% CI: 0.7,0.5-1.1). The range of senna doses was between 10 mg and 30 mg, but most pregnant women used 20 mg daily. The mothers with senna treatment showed the characteristics of pregnant women with constipation (eider with larger proportion of primiparae). There was no higher risk for 23 different CA groups after the senna treatment during the second and/or third gestational month of 260 mothers, i.e. in the critical period of most major CAs, compared with their 500 matched controls. Gestational age at delivery was somewhat longer (0.2 week) and the rate of preterm, birth was lower (6.6% vs. 9.2%) in newborn infants without CA born to mothers with senna treatment compared with babies born to mothers without senna treatment. In conclusion, senna treatment did not associate with a higher risk of CAs in the offspring of pregnant women with constipation. (C) 2009 Elsevier Inc. All rights reserved.