Boskovic Rada, Rudic Natasha, Danieliewska-Nikiel Barbara, Navioz Yvette, Koren Gideon
The Motherisk Program, The Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada.
Birth Defects Res A Clin Mol Teratol. 2004 Aug;70(8):528-30. doi: 10.1002/bdra.20040.
Case-control studies have suggested that the nausea and vomiting of pregnancy (NVP) may have a protective effect against specific malformations. These suggestions have been interpreted as if the lack of NVP may put mothers at an increased teratogenic risk.
A prospective, cohort-controlled study was done comparing pregnancy outcome in women not experiencing NVP with those experiencing NVP at two levels of clinical severity. Women who called the Motherisk program about first-trimester exposure to drugs and who had not experienced NVP were included as the study group. The NVP Healthline enrolled two control groups of women with NVP treated with a doxylamine-pyridoxine combination for morning sickness. These women were exposed during the first trimester of gestation to either higher than the standard dose (5-12 tablets/day) or a standard dose (1-4 tablets/day) of doxylamine-pyridoxine. The women in all three groups were followed up four to six months after the expected date of birth to ascertain pregnancy outcomes and child health.
There were no major malformations among offspring of 130 women not experiencing NVP. There were two major malformations among 246 women experiencing NVP. The two control groups of women with NVP had similar distributions of gestational ages, birth rates, as well as rates of miscarriages and stillbirths, as in the no-NVP group.
This study did not show an association between lack of NVP and an increase in the overall rates of major malformations.
病例对照研究表明，妊娠恶心和呕吐（NVP）可能对特定畸形具有保护作用。这些观点被解读为，缺乏NVP可能会使母亲面临更高的致畸风险。
进行了一项前瞻性队列对照研究，比较未经历NVP的女性与经历不同临床严重程度NVP的女性的妊娠结局。拨打母婴风险计划热线咨询孕早期药物暴露且未经历NVP的女性被纳入研究组。NVP健康热线招募了两组使用多西拉敏-吡哆醇组合治疗孕吐的NVP女性作为对照组。这些女性在妊娠头三个月接受了高于标准剂量（5 - 12片/天）或标准剂量（1 - 4片/天）的多西拉敏-吡哆醇治疗。三组女性均在预计分娩日期后四至六个月进行随访，以确定妊娠结局和儿童健康状况。
130名未经历NVP的女性的后代中没有出现重大畸形。246名经历NVP的女性中有两例重大畸形。NVP女性的两个对照组在胎龄分布、出生率以及流产和死产率方面与未经历NVP的组相似。
本研究未显示缺乏NVP与重大畸形总体发生率增加之间存在关联。
