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[1996 - 2004年捷克共和国孕期头三个月用药母亲后代的出生缺陷发生率]

[Birth defects' occurrence in offspring of mothers taking 1st trimester medication in the Czech Republic in 1996-2004].

作者信息

Sípek A, Gregor V, Horácek J, Masátová D

机构信息

Ustav pro péci o matku a díte, Praha.

出版信息

Ceska Gynekol. 2006 Jul;71(4):284-91.

Abstract

OBJECTIVE

An analysis of birth defects incidence in offspring of mothers taking 1st trimester medication in the Czech Republic in 1996-2004.

TYPE OF STUDY

A retrospective demographical-epidemiological analysis of data from a National Register of Congenital Anomalies of the Czech Republic.

METHODOLOGY

Data on birth defects in the Czech Republic from the Institute of Health Information and Statistics--National Register of Congenital Anomalies from the 1996-2004 period and a control group data on healthy children born to mothers taking medications from the same time period. Data on medication were analyzed in relation to particular defects and were also used in international databases.

RESULTS

There were 1,125 children born with a birth defect to mothers taking 1st trimester medication making a total of 1,456 particular birth defects. A control group covered 1,321 exposed women giving birth to a child without any birth defect. Some types of congenital heart defects, cleft lip with cleft palate and limb reduction defects. A significantly higher risk was found also in following 5 types of drugs: anticoagulants, antihypertensives, peripheral vasodilatants, urologics and antiepileptics.

CONCLUSIONS

A significantly higher risk was found for the following defects: anencephaly, spina bifida, congenital hydrocephalus, anophthalmia/microphthalmia and auricular and limb reduction defects. Although the results are not always unambiguous and are probably influenced by both information and recall bias, they complement data on adverse effects of drugs in pregnancy in the Czech Republic. They also stress the need for a high preliminary caution in drug prescription and for a complex and individual risk assessement by a clinical geneticist.

摘要

目的

分析1996 - 2004年捷克共和国孕期头三个月用药母亲所生子女的出生缺陷发生率。

研究类型

对捷克共和国先天性异常国家登记处数据进行回顾性人口统计学 - 流行病学分析。

方法

来自健康信息与统计研究所的捷克共和国1996 - 2004年期间先天性异常国家登记处的出生缺陷数据,以及同期用药母亲所生健康儿童的对照组数据。对用药数据针对特定缺陷进行分析,并用于国际数据库。

结果

孕期头三个月用药母亲所生的1125名儿童存在出生缺陷,共出现1456种特定出生缺陷。对照组涵盖1321名暴露于药物但所生孩子无任何出生缺陷的女性。某些类型的先天性心脏缺陷、唇腭裂和肢体短小缺陷。还发现以下5类药物导致出生缺陷的风险显著更高:抗凝剂、抗高血压药、外周血管扩张剂、泌尿科用药和抗癫痫药。

结论

发现以下缺陷的风险显著更高:无脑儿、脊柱裂、先天性脑积水、无眼/小眼畸形以及耳部和肢体短小缺陷。尽管结果并非总是明确无误,可能受到信息和回忆偏倚的影响,但它们补充了捷克共和国孕期用药不良反应的数据。它们还强调在药物处方时需要高度谨慎,并由临床遗传学家进行全面的个体风险评估。

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