Czeizel Andrew E, Kazy Zoltán, Vargha Peter
Foundation for the Community Control of Hereditary Diseases, Törökvész lejto 32, 1026 Budapest, Hungary.
Reprod Toxicol. 2003 Jul-Aug;17(4):387-91. doi: 10.1016/s0890-6238(03)00041-8.
The aim of this study was to investigate the teratogenicity of vaginal natamycin treatment during pregnancy, because the data of human epidemiological studies have not been published. Pair analysis of cases with congenital abnormalities and matched healthy controls was carried out. The population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996 included as total, 38,151 pregnant women who delivered newborn infants without any defects (control group) and 22,843 pregnant women who had fetuses or newborns with congenital abnormalities. 62 (0.27%) and 98 (0.26%) pregnant women were treated with the natamycin in the case and control groups, respectively (crude OR 1.1 with 95% CI: 0.8-1.5). A teratogenic potential of vaginal natamycin treatment during the second and third months of pregnancy, the critical period of most major congenital abnormalities, was not indicated in the case-control pair analysis (adjusted OR 0.9 with 95% CI: 0.4-1.8). A somewhat higher mean birth weight (72 g) was found in control newborn infants born to mothers with natamycin treatment compared with the data of control newborn infants without this treatment (adjusted P=0.01), though mean gestational age was shorter. The conclusion of this study is that the treatment with vaginal natamycin during pregnancy presents no detectable teratogenic risk to the fetus.
本研究的目的是调查孕期阴道用那他霉素的致畸性,因为人类流行病学研究数据尚未发表。对先天性异常病例与匹配的健康对照进行了配对分析。1980年至1996年间匈牙利先天性异常病例对照监测的基于人群的数据集总共包括38151名分娩无任何缺陷新生儿的孕妇(对照组)和22843名胎儿或新生儿有先天性异常的孕妇。病例组和对照组分别有62名(0.27%)和98名(0.26%)孕妇接受了那他霉素治疗(粗比值比为1.1,95%可信区间:0.8 - 1.5)。病例对照配对分析未显示在妊娠第二和第三个月(大多数主要先天性异常的关键时期)阴道用那他霉素治疗有致畸潜力(校正比值比为0.9,95%可信区间:0.4 - 1.8)。与未接受该治疗的对照新生儿数据相比,接受那他霉素治疗的母亲所生对照新生儿的平均出生体重略高(72克)(校正P = 0.01),尽管平均孕周较短。本研究的结论是,孕期阴道用那他霉素治疗对胎儿无明显致畸风险。