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孕期暴露于异维甲酸后严重畸形的发生率:一项系统评价和荟萃分析。

The rates of major malformations after gestational exposure to isotretinoin: a systematic review and meta-analysis.

作者信息

Choi Eun Jeong, Kim NaeRy, Kwak Ho-Seok, Han Hae Ji, Chun Kyoung-Chul, Kim Young-Ah, Koh Jae-Whoan, Han Jung Yeol, Joo Sung Hong, Lee Ji Sung, Koren Gideon

机构信息

Korean Mothersafe Counselling Center, Pregnancy & Breastfeeding Medicines Information Center, Seoul, Korea.

Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital, Goyang, Korea.

出版信息

Obstet Gynecol Sci. 2021 Jul;64(4):364-373. doi: 10.5468/ogs.20373. Epub 2021 Mar 17.

DOI:10.5468/ogs.20373
PMID:33757281
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8290153/
Abstract

OBJECTIVE

Isotretinoin is among the most notorious human teratogens, documented originally as causing up to 30% of malformations. This systematic review and meta-analysis aimed to evaluate the rates of major malformation (MM) among isotretinoin-exposed pregnant women over the years through a systematic review and meta-analysis.

METHODS

Eligible studies were searched and identified using various databases. Single-arm meta-analysis and meta-analysis of odd ratios among controlled studies were performed using Review Manager version 5.3.

RESULTS

Ten eligible studies that combined 2,783 isotretinoin-exposed women were included in our study. The rate of MM weighted for the sample size was 15%. Three studies that included an unexposed comparison group were eligible for the meta-analysis. The pooled odds ratio of MM for isotretinoin-exposed women was 3.76. After 2006, the pooled odds ratio of MM for isotretinoin exposure was significantly lower at 1.04.

CONCLUSION

The current rate of MM in isotretinoin-exposed women was substantially lower after 2006.

摘要

目的

异维甲酸是最臭名昭著的人类致畸剂之一,最初记录显示其致畸率高达30%。本系统评价和荟萃分析旨在通过系统评价和荟萃分析评估多年来暴露于异维甲酸的孕妇中严重畸形(MM)的发生率。

方法

使用各种数据库检索并识别符合条件的研究。使用Review Manager 5.3软件进行单臂荟萃分析以及对照研究中比值比的荟萃分析。

结果

我们的研究纳入了10项符合条件的研究,共涉及2783名暴露于异维甲酸的女性。按样本量加权后的MM发生率为15%。三项纳入未暴露对照组的研究符合荟萃分析条件。暴露于异维甲酸的女性发生MM的合并比值比为3.76。2006年后,暴露于异维甲酸的女性发生MM的合并比值比显著降低,为1.04。

结论

2006年后,暴露于异维甲酸的女性当前的MM发生率大幅降低。

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本文引用的文献

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Depression, isotretinoin, and folic acid: A practical review.抑郁症、异维 A 酸和叶酸:实用综述。
Dermatol Ther. 2019 Nov;32(6):e13104. doi: 10.1111/dth.13104. Epub 2019 Oct 14.
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Identifying pregnancies in insurance claims data: Methods and application to retinoid teratogenic surveillance.在保险理赔数据中识别妊娠情况:方法及其在维甲酸致畸监测中的应用。
Pharmacoepidemiol Drug Saf. 2019 Sep;28(9):1211-1221. doi: 10.1002/pds.4794. Epub 2019 Jul 22.
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Obstet Gynecol Sci. 2022 Mar;65(2):166-175. doi: 10.5468/ogs.21354. Epub 2022 Feb 23.
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Advantages of Tailored Isotretinoin Treatment in Moderate to Severe Acne: Real-Life Data.中度至重度痤疮中个体化异维A酸治疗的优势:真实世界数据
Front Pharmacol. 2021 Nov 12;12:733526. doi: 10.3389/fphar.2021.733526. eCollection 2021.
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Homocysteine, folic acid, and vitamin B12 levels in patients on isotretinoin therapy for acne vulgaris: A meta-analysis.寻常痤疮患者接受异维A酸治疗时的同型半胱氨酸、叶酸和维生素B12水平:一项荟萃分析。
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Oral hormone pregnancy tests and the risks of congenital malformations: a systematic review and meta-analysis.口服激素妊娠试验与先天性畸形风险:系统评价与荟萃分析
F1000Res. 2018 Oct 31;7:1725. doi: 10.12688/f1000research.16758.2. eCollection 2018.
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Isotretinoin exposure in pregnant women in Korea.韩国孕妇异维A酸暴露情况。
Obstet Gynecol Sci. 2018 Nov;61(6):649-654. doi: 10.5468/ogs.2018.61.6.649. Epub 2018 Oct 12.
7
Pretreatment Effect of Folic Acid on 13-Cis-RA-Induced Cellular Damage of Developing Midfacial Processes in Cultured Rat Embryos.叶酸对13-顺式维甲酸诱导的培养大鼠胚胎发育中面部过程细胞损伤的预处理作用
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