Maternal exposure to amoxicillin and the risk of oral clefts.
Maternal exposure to amoxicillin and the risk of oral clefts.
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孕产妇暴露于阿莫西林和口腔裂口的风险。
DOI：
10.1097/ede.0b013e318258cb05
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Hernández-Díaz S
中科院分区：
文献类型：
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作者：
Lin KJ;Mitchell AA;Yau WP;Louik C;Hernández-Díaz S
先前的研究表明，在怀孕早期接触阿莫西林后，口腔裂的风险增加，但结果一直不一致。从1994年到2008年，在斯隆流行病学中心出生缺陷研究的参与者中，我们确定了877名唇裂伴/不伴腭裂（CL/P）的婴儿和471名单纯腭裂（CP）的婴儿。对照组包括6952名非畸形婴儿。母亲们接受了关于人口统计学、生殖和医疗因素以及药物使用细节的采访。我们使用条件logistic回归估计了与妊娠早期使用阿莫西林相关的比值比（OR）和95%置信区间（CI），并调整了已知的唇腭裂风险因素，以及感染、发热和伴随治疗。在对照组中，3%的妇女在妊娠早期使用阿莫西林。母亲使用阿莫西林与CL/P风险增加相关（校正OR= 2.0 [95% CI= 1.0-4.1]），妊娠第3个月使用的OR为4.3（1.4-13.0）。使用其他青霉素类或头孢菌素类药物的风险未升高。对于CP，妊娠早期使用阿莫西林的OR为1.0（0.4-2.3），妊娠第三个月使用阿莫西林的OR为7.1（1.4-36.4）。妊娠早期使用阿莫西林可能与口裂风险增加有关。
Prior studies have suggested an increased risk of oral clefts after exposure to amoxicillin in early pregnancy, but findings have been inconsistent. Among participants in the Slone Epidemiology Center Birth Defects Study from 1994 to 2008, we identified 877 infants with cleft lip with/without cleft palate (CL/P) and 471 with cleft palate alone (CP). Controls included 6952 non-malformed infants. Mothers were interviewed about demographic, reproductive and medical factors, and details of medication use. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of amoxicillin in the first trimester using conditional logistic regression and adjusting for known risk factors for oral clefts, as well as for infections, fever, and concomitant treatments. In the control group, 3% of women had used amoxicillin in the first trimester. Maternal use of amoxicillin was associated with an increased risk of CL/P (adjusted OR= 2.0 [95% CI= 1.0–4.1]), with an OR of 4.3 (1.4–13.0) for third-gestational-month use. Risks were not elevated for use of other penicillins or cephalosporins. For CP, the OR for first-trimester amoxicillin was 1.0 (0.4–2.3), with an OR of 7.1 (1.4–36.4) for third-gestational-month use. Amoxicillin use in early pregnancy may be associated with an increased risk of oral clefts.