Korean Motherisk Program, Kwandong University School of Medicine, Seoul, Republic of Korea.
Intern Med J. 2013 May;43(5):513-8. doi: 10.1111/imj.12043.
BACKGROUND/AIM: Little is known about exposures to low radiation doses in the first trimester of pregnancy and deterministic adverse effects in the offspring, and risks are extrapolated from catastrophic events or from exposures to radiotherapy. The study aimed to assess the foetal and neonatal outcomes of pregnant women exposed to radiodiagnostic procedures with abdominal or lumbar irradiation.
In a prospective cohort design, we studied the foetal and neonatal outcomes in 115 singleton pregnant women who required abdominal or lumbar radiodiagnostic procedures without the administration of radionucleotides, and in 527 age-matched (± 2 years) control pregnant women.
In the exposed group, lumbar spine radiography (33.9%), plain abdominal radiography (16.5%) and upper gastrointestinal tract radiography with abdominal irradiation (15.7%) were the most common radiodiagnostic procedures. Major congenital malformations were identified in two (1.9%) babies born in the exposed group and in two (0.4%) babies born in the control group (odds ratio = 4.7; 95% confidence interval 0.7-33.6; P = 0.15). The rest of the foetal and neonatal outcomes was similar in the two groups except by a marginally higher rate of admissions to the neonatal intensive care unit among babies born to exposed women (odds ratio = 2.9; 95% confidence interval 1.0-9.4; P = 0.06).
Our results indicate that X-ray and computed tomography scan exposure involving abdominal irradiation without the administration of radionucleotides is not associated with adverse foetal and neonatal deterministic outcomes. Efforts are required to reduce the use of radiodiagnostic procedures for general check-ups in childbearing age women.
背景/目的:人们对怀孕早期接触低剂量辐射和胎儿确定性不良反应知之甚少,风险是从灾难性事件或放射治疗暴露中推断出来的。本研究旨在评估接受腹部或腰部放射诊断程序照射的孕妇的胎儿和新生儿结局。
在一项前瞻性队列设计中,我们研究了 115 名需要进行腹部或腰部放射诊断程序但未给予放射性核素的单胎孕妇和 527 名年龄匹配(±2 岁)的对照孕妇的胎儿和新生儿结局。
在暴露组中,腰椎摄影(33.9%)、腹部平片(16.5%)和腹部照射的上消化道造影(15.7%)是最常见的放射诊断程序。在暴露组中,有 2 名(1.9%)婴儿和对照组中 2 名(0.4%)婴儿发现主要先天性畸形(比值比=4.7;95%置信区间 0.7-33.6;P=0.15)。除了暴露组婴儿中新生儿重症监护病房入住率略高外(比值比=2.9;95%置信区间 1.0-9.4;P=0.06),两组其余胎儿和新生儿结局相似。
我们的结果表明,不给予放射性核素的腹部照射的 X 射线和计算机断层扫描暴露与胎儿和新生儿确定性不良结局无关。需要努力减少育龄妇女一般检查中放射诊断程序的使用。