孕期辐射暴露:土耳其女性的结局、认知和致畸咨询。
Radiation exposure in pregnancy: outcomes, perceptions and teratological counseling in Turkish women.
机构信息
From the Medical Genetics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
From the Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
出版信息
Ann Saudi Med. 2022 May-Jun;42(3):214-221. doi: 10.5144/0256-4947.2022.03.03.1200. Epub 2022 Jun 2.
BACKGROUND
Fetal effects of radiation are associated with the gestational week of exposure, dose, and duration of exposure, but the perception of risk of radiation in expecting mothers is greater than the actual risk of physical effects.
OBJECTIVES
Evaluate the overestimation of the teratogenic risk in women exposed to radiation and the role of teratological counseling in minimizing preconceptions.
DESIGN
Analytical, cross-sectional.
SETTING
Tertiary care center, genetic diseases diagnosis center.
PATIENTS AND METHODS
Out of 10 784 people who applied for teratological consultation between 2009 and 2018, pregnant women meeting inclusion criteria and exposed to radiation were selected as the study group; pregnant women without radiation exposure were selected as the control group. Two subgroups of the study group based on the week and dose of exposure were also analyzed.
MAIN OUTCOME MEASURES
Abortion rate, termination recommendation rates before and after teratological counseling.
SAMPLE SIZE
461 pregnant exposed to radiation; 213 pregnant women without radiation exposure.
RESULTS
Preterm birth and termination rates differed significantly between cases and controls (=.038, =.019, respectively). Termination recommendation at the first examination was more frequent for both the week of exposure overall and dose subgroups comparing cases and controls (<.001). In the comparison of subgroups by week of exposure, only the miscarriage rate was statistically significant (=.007). After teratological counseling termination decision rates were significantly decreased (<.001).
CONCLUSION
Subjective perceptions about the risks of radiation may lead to the termination of an otherwise wanted pregnancy. Teratological counseling is crucial for the prevention of termination of pregnancy, clarifying misinformation, and minimizing anxiety.
LIMITATIONS
With the exception of measurable values as calculated doses of radiation, the conclusions are mostly derived from medical records and subjective responses of pregnant women. The termination rates in our study probably do not reflect the whole population.
CONFLICT OF INTEREST
None.
背景
胎儿辐射效应与暴露的孕龄、剂量和暴露时间有关,但孕妇对辐射风险的感知大于实际的物理效应风险。
目的
评估暴露于辐射的孕妇对致畸风险的高估,以及产前咨询在减少误解方面的作用。
设计
分析性、横断面研究。
地点
三级保健中心、遗传疾病诊断中心。
患者和方法
在 2009 年至 2018 年间申请产前咨询的 10784 人中,选择符合纳入标准并暴露于辐射的孕妇作为研究组;选择未暴露于辐射的孕妇作为对照组。还根据暴露的周数和剂量对研究组进行了两个亚组分析。
主要观察指标
流产率、产前咨询前后的终止建议率。
样本量
461 名暴露于辐射的孕妇;213 名未暴露于辐射的孕妇。
结果
病例组和对照组的早产和终止率差异有统计学意义(=0.038,=0.019)。在总体暴露周数和剂量亚组中,首次检查时的终止建议频率均高于对照组(<0.001)。在按暴露周数划分的亚组比较中,仅流产率有统计学意义(=0.007)。产前咨询后,终止决策率显著下降(<0.001)。
结论
对辐射风险的主观感知可能导致原本期望的妊娠终止。产前咨询对于预防终止妊娠、澄清误解和减轻焦虑至关重要。
局限性
除了可测量的辐射剂量外,结论主要来自于病历和孕妇的主观反应。我们的研究中的终止率可能无法反映整个人群。
利益冲突
无。