Cook Michael N, Olshan Andrew F, Guess Harry A, Savitz David A, Poole Charles, Blatt Julie, Bondy Melissa L, Pollock Brad H
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Epidemiol. 2004 Apr 15;159(8):721-31. doi: 10.1093/aje/kwh108.
The association between a mother's use of specific medications during pregnancy and lactation and neuroblastoma in her offspring was evaluated in a case-control study. Newly diagnosed cases of neuroblastoma (n=504) in the United States and Canada were identified between 1992 and 1994 at 139 hospitals affiliated with the Pediatric Oncology Group or the Children's Cancer Group clinical trial programs. One age-matched control was sampled from the community of each case by means of random digit dialing. Exposure information was ascertained retrospectively from mothers in a structured telephone interview. Odds ratios were estimated using conditional logistic regression, with adjustment for maternal sociodemographic factors. The results did not support an association between neuroblastoma and maternal exposure to diuretic agents, antiinfective agents, estrogens, progestins, sedatives, anticonvulsant drugs, or drugs that may form N-nitroso derivatives. Mothers of cases were more likely to report using medications containing opioid agonists while they were pregnant or nursing than were mothers of controls (odds ratio=2.4, 95% confidence interval: 1.3, 4.3). Specifically, more mothers of cases reported using medications containing codeine while pregnant or nursing than did mothers of controls (odds ratio=3.4, 95% confidence interval: 1.4, 8.4). This preliminary finding may be due to bias, confounding, or chance, and additional studies are needed for confirmation.
在一项病例对照研究中,评估了母亲在孕期和哺乳期使用特定药物与其后代神经母细胞瘤之间的关联。1992年至1994年间,在美国和加拿大的139家隶属于儿科肿瘤学组或儿童癌症组临床试验项目的医院中,确定了新诊断的神经母细胞瘤病例(n = 504)。通过随机数字拨号从每个病例所在社区抽取一名年龄匹配的对照。通过结构化电话访谈,从母亲那里回顾性地确定暴露信息。使用条件逻辑回归估计比值比,并对母亲的社会人口统计学因素进行调整。结果不支持神经母细胞瘤与母亲接触利尿剂、抗感染药、雌激素、孕激素、镇静剂、抗惊厥药或可能形成N - 亚硝基衍生物的药物之间存在关联。病例组的母亲比对照组的母亲更有可能报告在怀孕或哺乳期间使用含阿片类激动剂的药物(比值比 = 2.4,95%置信区间:1.3,4.3)。具体而言,与对照组母亲相比,更多病例组的母亲报告在怀孕或哺乳期间使用含可待因的药物(比值比 = 3.4,95%置信区间:1.4,8.4)。这一初步发现可能是由于偏倚、混杂因素或偶然性导致的,需要进一步研究加以证实。