Källén Bengt
Tornblad Institute, University of Lund, Sweden.
Cleft Palate Craniofac J. 2003 Nov;40(6):624-8. doi: 10.1597/02-077.
To study the association between maternal drug use in early pregnancy and orofacial cleft in the infant.
Register analysis based on prospectively collected information.
All delivered women in Sweden July 1, 1995, through December 31, 2001.
Presence of orofacial cleft in infant.
Prospective information on maternal drug use during the first trimester, as reported in early pregnancy, was studied in 1142 infants with orofacial clefts, isolated or with other malformations, excluding chromosome anomalies. Any drug use was not associated with clefts (odds ratio [OR] = 0.98, 95% confidence interval [95% CI] = 0.85 to 1.13), with isolated clefts (OR = 0.92) with isolated median cleft palate (OR = 1.03, 95% CI = 0.79 to 1.36) or with isolated cleft lip with or without cleft palate (OR = 0.86, 95% CI = 0.71 to 1.05). Reported use of multivitamins, folic acid, or B(12) was not associated with a decrease in orofacial cleft risk (OR = 1.00, 95% CI = 0.63 to 1.52). ORs above 2 were seen for some drugs: sulfasalazine, naproxen, and anticonvulsants, but only a few exposed cases occurred. An association between glucocorticoid use and infant cleft was indicated and seemed to be strongest for median cleft palate.
Maternal drug use seems to play only a small role for the origin of orofacial clefts, at least in Sweden.
研究孕早期母亲用药与婴儿口面部裂隙之间的关联。
基于前瞻性收集信息的登记分析。
1995年7月1日至2001年12月31日在瑞典分娩的所有女性。
婴儿口面部裂隙的存在情况。
对1142例有口面部裂隙（孤立性或合并其他畸形，不包括染色体异常）的婴儿，研究了其母亲在孕早期报告的孕早期用药情况。任何药物使用与裂隙均无关联（优势比[OR]=0.98，95%置信区间[95%CI]=0.85至1.13），与孤立性裂隙（OR=0.92）、孤立性腭裂（OR=1.03，95%CI=0.79至1.36）或孤立性唇裂伴或不伴腭裂（OR=0.86，95%CI=0.71至1.05）均无关联。报告使用多种维生素、叶酸或维生素B12与口面部裂隙风险降低无关联（OR=1.00，95%CI=0.63至1.52）。某些药物的OR值高于2：柳氮磺胺吡啶、萘普生和抗惊厥药，但仅出现少数暴露病例。提示糖皮质激素使用与婴儿腭裂之间存在关联，且似乎对腭裂最为显著。
至少在瑞典，母亲用药对口面部裂隙的发生似乎仅起很小的作用。
