准父亲孕前接触甲氨蝶呤后的生育结局：一项全国性队列研究。
Birth outcomes after preconception paternal exposure to methotrexate: A nationwide cohort study.
机构信息
Center for Crohn's and Colitis, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, University of Southern Denmark, Odense, Denmark.
出版信息
Reprod Toxicol. 2017 Dec;74:219-223. doi: 10.1016/j.reprotox.2017.10.004. Epub 2017 Nov 12.
BACKGROUND
Methotrexate (MTX), a folic acid antagonist, is often prescribed for moderate to severe inflammatory related diseases. The safety of paternal MTX use prior to conception is unknown. This study, using the National Danish Registries, aimed to examine the association between paternal MTX use three months before conception and adverse birth outcomes.
RESULTS
Children fathered by men treated with MTX within three months before conception constituted the exposed cohort (N=193), and children fathered by men not treated with MTX constituted the unexposed cohort (N=1,013,801). The adjusted odds ratio (OR) for preterm birth was 1.38 (95% CI:0.68-2.81). The adjusted ORs of congenital anomalies (CAs) and small for gestational age (SGA) were 1.10 (95% CI:0.57-2.13) and 0.98 (95% CI:0.39-2.50), respectively.
CONCLUSION
Our results regarding the effect of paternal use of MTX within 3 months before conception on birth outcomes of CAs, preterm birth and SGA are overall reassuring.
背景
甲氨蝶呤（MTX）是一种叶酸拮抗剂，常用于治疗中度至重度炎症相关疾病。目前尚不清楚男性在受孕前三个月内使用 MTX 的安全性。本研究利用丹麦全国注册数据库，旨在探讨男性在受孕前三个月内使用 MTX 与不良出生结局之间的关系。
结果
在受孕前三个月内接受 MTX 治疗的男性所生育的子女为暴露组（N=193），而未接受 MTX 治疗的男性所生育的子女为未暴露组（N=1,013,801）。调整后的早产比值比（OR）为 1.38（95%CI：0.68-2.81）。先天性畸形（CA）和小于胎龄儿（SGA）的调整比值比（OR）分别为 1.10（95%CI：0.57-2.13）和 0.98（95%CI：0.39-2.50）。
结论
我们的研究结果表明，男性在受孕前三个月内使用 MTX 对 CA、早产和 SGA 等出生结局的影响总体上是令人放心的。
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