孕期使用皮质类固醇。局部、吸入或全身用药会带来风险吗？
Using corticosteroids during pregnancy. Are topical, inhaled, or systemic agents associated with risk?
作者信息
Oren D, Nulman I, Makhija M, Ito S, Koren Gideon
机构信息
Motherisk Team, Hospital for Sick Children, Toronto, Ont.
出版信息
Can Fam Physician. 2004 Aug;50:1083-5.
Abstract
QUESTION
I am concerned about use of corticosteroids during pregnancy. Some of my women patients of reproductive age are using topical, inhaled, or oral preparations, and I am not sure what to advise.
ANSWER
Both topical and systemic corticosteroids are used for a variety of autoimmune and inflammatory conditions. Results of first-trimester studies were inconclusive and underpowered. Recent meta-analyses suggest a small but significant association between use of systemic corticosteroids during the first trimester and oral clefts. This is consistent with results of animal studies. No similar evidence exists for topical or inhaled corticosteroids, probably because of much lower systemic exposure.
摘要
问题
我担心孕期使用皮质类固醇。我的一些育龄期女性患者正在使用局部、吸入或口服制剂，我不确定该给出什么建议。
答案
局部和全身皮质类固醇都用于多种自身免疫性和炎症性疾病。孕早期研究结果尚无定论且效力不足。近期的荟萃分析表明，孕早期使用全身皮质类固醇与口腔腭裂之间存在小但显著的关联。这与动物研究结果一致。对于局部或吸入皮质类固醇，不存在类似证据，可能是因为全身暴露量低得多。
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