Pradat Pierre, Robert-Gnansia Elisabeth, Di Tanna Gian Luca, Rosano Aldo, Lisi Alessandra, Mastroiacovo Pierpaolo
Institut Européen des Génomutations, Lyon, France.
Birth Defects Res A Clin Mol Teratol. 2003 Dec;67(12):968-70. doi: 10.1002/bdra.10134.
The possible association between oral cleft in the newborn and maternal exposure to corticoids during pregnancy is still controversial. The aim of this study was to test this association by a case-control analysis using the large multicentric MADRE database.
The MADRE database is a collection of information on malformed infants with a history of maternal first-trimester drug exposure. Nine malformation registries participate in the data collection. Cases were defined as infants presenting with a cleft palate or cleft lip, and exposure was defined by the use of corticosteroids during the first trimester of pregnancy.
After 12 years of data collection, the database includes data on 11,150 malformed infants. A slight association is observed between exposure to corticoids for systemic use and the occurrence of cleft lip with or without cleft palate (OR, 2.59; 95% CI, 1.18-5.67).
If the observed association is real, an interpretation is suggested, based on a likely interaction between corticosteroids and environmental dioxins. It is indeed possible that human fetuses may become sensitive to the teratogenic effect of corticosteroids when they are exposed in utero to environmental pesticides as well.
新生儿唇腭裂与孕期母亲接触皮质类固醇之间的可能关联仍存在争议。本研究的目的是通过使用大型多中心MADRE数据库进行病例对照分析来检验这种关联。
MADRE数据库收集了有孕早期母亲药物暴露史的畸形婴儿的信息。九个畸形登记处参与了数据收集。病例定义为患有腭裂或唇裂的婴儿，暴露定义为孕期头三个月使用皮质类固醇。
经过12年的数据收集，该数据库包含了11150名畸形婴儿的数据。观察到全身使用皮质类固醇与唇裂伴或不伴腭裂的发生之间存在轻微关联（比值比，2.59；95%置信区间，1.18 - 5.67）。
如果观察到的关联是真实的，则基于皮质类固醇与环境二恶英之间可能的相互作用提出一种解释。当人类胎儿在子宫内也接触环境杀虫剂时，确实有可能对皮质类固醇的致畸作用变得敏感。
