Martínez-Frías M L, Salvador J
ECEMC, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Eur J Epidemiol. 1990 Jun;6(2):118-23. doi: 10.1007/BF00145783.
Reports of the human teratogenicity of retinoids have raised concern about the potential human teratogenicity of high doses of vitamin A. Nevertheless, there are few human case reports of excess intake of vitamin A during pregnancy and defective outcomes. No epidemiological studies have been carried out on this subject. Here we present the results of an epidemiological study of prenatal exposure to high doses of vitamin A in Spain, using data from the Spanish hospital-based, case-control registry. Although it is difficult to reach conclusions with such a very low exposure level (1.3 per 1,000 livebirths), our results suggest that a teratogenic effect might exist for exposures to high doses of vitamin A (OR = 0.5, p = 0.15 for less than 40,000 IU and OR = 2.7, p = 0.06 for 40,000 IU or more). As we might expect, this effect also seems to be related to the organogenetic status (OR = 5.4, p = 0.1 for 1st-2nd month, OR = 1.8, p = 0.4 for 3rd onwards) at the time of exposure.
类视黄醇对人类有致畸性的报道引发了人们对高剂量维生素A潜在致畸性的担忧。然而,关于孕期维生素A摄入过量及不良后果的人类病例报告很少。尚未针对该主题开展过流行病学研究。在此,我们利用西班牙基于医院的病例对照登记处的数据,呈现西班牙高剂量维生素A产前暴露的流行病学研究结果。尽管在如此低的暴露水平下(每1000例活产中有1.3例)很难得出结论,但我们的结果表明,高剂量维生素A暴露可能存在致畸效应(低于40000国际单位时,比值比=0.5,p=0.15;40000国际单位及以上时,比值比=2.7,p=0.06)。正如我们所预期的,这种效应似乎也与暴露时的器官发生状态有关(第1至2个月时,比值比=5.4,p=0.1;第3个月及以后,比值比=1.8,p=0.4)。