与宫内暴露于叶酸拮抗剂相关的叶酸敏感型出生缺陷。
Folic acid sensitive birth defects in association with intrauterine exposure to folic acid antagonists.
作者信息
Meijer Willemijn M, de Walle Hermien E K, Kerstjens-Frederikse Wilhelmina S, de Jong-van den Berg Lolkje T W
机构信息
Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen University Institute for Drug Exploration (GUIDE), Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
出版信息
Reprod Toxicol. 2005 Jul-Aug;20(2):203-7. doi: 10.1016/j.reprotox.2005.01.008.
Since the protective effect of folic acid (FA) on birth defects is well known, it is reasonable to assume intrauterine exposure to FA antagonists increases the risk on these defects. We have therefore performed case-control analyses to investigate the risk of intrauterine exposure to FA antagonists, using data on births from the EUROCAT Northern Netherlands registry from 1997 to 2002. Of the 815 cases, 11 were exposed to a FA antagonist compared to 16 of the 1402 controls. For FA sensitive defects as a group, the study showed no effect after exposure to a FA antagonist (odds ratio (OR)=1.18, 95% CI: 0.55-2.57). We found no effect after exposure to a dihydrofolate reductase inhibitor (DHFRI) (OR 0.44, 95% CI: 0.12-1.54), but we did find a statistically significant effect after exposure to an antiepileptic drug (OR=3.45, 95% CI: 1.04-11.48). This study supports the findings of various other studies on the teratogenicity of antiepileptics. An association between DHFRIs and FA sensitive defects was not found.
由于叶酸（FA）对出生缺陷的保护作用众所周知，因此可以合理推测子宫内接触FA拮抗剂会增加出现这些缺陷的风险。因此，我们利用1997年至2002年荷兰北部EUROCAT登记处的出生数据进行了病例对照分析，以调查子宫内接触FA拮抗剂的风险。在815例病例中，有11例接触过FA拮抗剂，而在1402例对照中有16例接触过。对于作为一个整体的FA敏感缺陷，该研究显示接触FA拮抗剂后没有影响（优势比（OR）=1.18，95%置信区间：0.55-2.57）。我们发现接触二氢叶酸还原酶抑制剂（DHFRI）后没有影响（OR 0.44，95%置信区间：0.12-1.54），但我们确实发现接触抗癫痫药物后有统计学上的显著影响（OR=3.45，95%置信区间：1.04-11.48）。这项研究支持了其他关于抗癫痫药致畸性的各种研究结果。未发现DHFRI与FA敏感缺陷之间存在关联。
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