Safety of macrolides during pregnancy.
Safety of macrolides during pregnancy.
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DOI：
10.1016/j.ajog.2012.12.023
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发表时间：
2013-03
影响因子：
9.8
通讯作者：
Hernandez-Diaz, Sonia
中科院分区：
文献类型：
--
作者：
Lin, Kueiyu Joshua;Mitchell, Allen A.;Yau, Wai-Ping;Louik, Carol;Hernandez-Diaz, Sonia
先前的研究报告称，产前接触大环内酯类抗生素后，先天性心脏病（CHD）和幽门狭窄（PS）的风险增加。我们试图评估母亲使用红霉素和非红霉素大环内酯类药物与 CHD 和 PS 风险之间的关联。在1994年至2008年斯隆流行病学中心出生缺陷研究的参与者中，我们确定了4132名患有CHD的婴儿和735名患有PS的婴儿作为病例，以及6952名没有任何畸形的婴儿作为对照。我们使用条件逻辑回归并调整 CHD 和 PS、发烧、特定类型的感染及其相关治疗的危险因素，估计了与每个妊娠期使用红霉素或非红霉素大环内酯类药物相关的比值比 (OR) 和 95% 置信区间 (CI)。在妊娠早期，分别有 0.4% 和 0.7% 的对照女性使用过红霉素和非红霉素大环内酯类药物。与怀孕期间不使用红霉素相比，妊娠早期接触红霉素与 CHD（OR，1.3；95% CI，0.6-2.6）或 PS（OR，0.9；95% CI，0.3-3.0）风险增加无关。非红霉素大环内酯类药物的相应 OR 对于 CHD 为 0.7 (95% CI, 0.4–1.3)，对于 PS 为 1.7 (95% CI, 0.6–4.6)。我们发现妊娠晚期接触红霉素或非红霉素大环内酯类药物与 PS 风险之间没有关联。假设生成分析并未发现母亲使用大环内酯类药物与其他常见特定出生缺陷之间存在明显关联。我们发现与妊娠期使用大环内酯类药物相关的 CHD、PS 和其他常见畸形的风险之间没有有意义的关联。
Prior studies have reported increased risks of congenital heart defects (CHD) and pyloric stenosis (PS) after prenatal exposure to macrolide antibiotics. We sought to assess the association between maternal use of erythromycin and non-erythromycin macrolides and the risks of CHD and PS. Among participants in the Slone Epidemiology Center Birth Defects Study from 1994 to 2008, we identified 4132 infants with CHD and 735 with PS as cases, and 6952 infants without any malformation as controls. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of erythromycin or non-erythromycin macrolides in each trimester using conditional logistic regression and adjusting for risk factors for CHD and PS, fever, specific types of infections, and their associated treatments. During the first trimester, 0.4% and 0.7% of control women had used erythromycin and non-erythromycin macrolides, respectively. Compared to non-use during pregnancy, first-trimester exposure to erythromycin was not associated with an increased risk of CHD (OR, 1.3; 95% CI, 0.6–2.6) or PS (OR, 0.9; 95% CI, 0.3–3.0). The corresponding ORs for non-erythromycin macrolides were 0.7 (95% CI, 0.4–1.3) for CHD and 1.7 (95% CI, 0.6–4.6) for PS. We found no association between third-trimester exposure to erythromycin or non-erythromycin macrolides and the risk of PS. Hypothesis generation analyses did not identify appreciable associations between maternal use of macrolides and other common specific birth defects. We found no meaningful associations between the risks of CHD, PS, and other common malformations in relation to use of macrolides in pregnancy.
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影响因子：
2.8
作者：
Cooper WO;Hernandez-Diaz S;Arbogast PG;Dudley JA;Dyer SM;Gideon PS;Hall KS;Kaltenbach LA;Ray WA
通讯作者：
Ray WA
影响因子：
9.8
作者：
Mitchell AA;Gilboa SM;Werler MM;Kelley KE;Louik C;Hernández-Díaz S;National Birth Defects Prevention Study
通讯作者：
National Birth Defects Prevention Study
影响因子：
2.6
作者：
Yau, Wai-Ping;Lin, Kueiyu Joshua;Werler, Martha M.;Louik, Carol;Mitchell, Allen A.;Hernandez-Diaz, Sonia
通讯作者：
Hernandez-Diaz, Sonia
DOI：
10.1001/archpediatrics.2009.188
发表时间：
2009-11-01
影响因子：
--
作者：
Crider, Krista S.;Cleves, Mario A.;Hu, Dale J.
通讯作者：
Hu, Dale J.
影响因子：
7.2
作者：
Cooper, WO;Ray, WA;Griffin, MR
通讯作者：
Griffin, MR