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孕期用药与胎儿先天性异常之间的关联。

Associations between drugs administered during pregnancy and congenital abnormalities of the fetus.

作者信息

Nelson M M, Forfar J O

出版信息

Br Med J. 1971 Mar 6;1(5748):523-7. doi: 10.1136/bmj.1.5748.523.

Abstract

In a retrospective study to compare the drug consumption during pregnancy of mothers of infants with congenital abnormalities and of those without, over 97% of 1,369 mothers took prescribed drugs and 65% self-administered drugs. Significantly more mothers of infants with congenital abnormalities took aspirin, antacids, dextroamphetamine, phenobarbitone, sodium amytal, other barbiturates, cough medicines, iron, sulphonamides, and nicotinamide than mothers in the control group. However, most mothers taking analgesics, antacids, appetite suppressants, barbiturates, cough medicines, iron, sulphonamides, and vitamins produced normal infants. Any teratogenic effect of these drugs is therefore one of low potency. On the other hand, deficiencies such as those of ascorbic acid and folic acid may have a teratogenic effect. There is need for caution in presuming teratogenic effects on the basis of the associations shown here. During pregnancy, however, it would appear wise to avoid the administration of any drug which carries a suspicion of teratogenicity unless that drug is specifically indicated, and self-medication with common household remedies such as aspirin and antacids should be avoided. These recommendations would also apply to any woman of childbearing age in whom conception is likely.

摘要

在一项回顾性研究中,为比较患有先天性异常婴儿的母亲与未患先天性异常婴儿的母亲在孕期的药物使用情况,1369名母亲中超过97%服用过处方药,65%自行用药。与对照组母亲相比,患有先天性异常婴儿的母亲服用阿司匹林、抗酸剂、右旋苯丙胺、苯巴比妥、异戊巴比妥钠、其他巴比妥类药物、止咳药、铁剂、磺胺类药物和烟酰胺的比例显著更高。然而,大多数服用镇痛药、抗酸剂、食欲抑制剂、巴比妥类药物、止咳药、铁剂、磺胺类药物和维生素的母亲生出的婴儿是正常的。因此,这些药物的任何致畸作用都很微弱。另一方面,诸如抗坏血酸和叶酸缺乏等情况可能有致畸作用。基于此处所示的关联来假定致畸作用时需要谨慎。然而,在孕期,除非有明确指征,否则避免使用任何可疑有致畸性的药物似乎是明智的,并且应避免自行服用阿司匹林和抗酸剂等常见家庭用药。这些建议也适用于任何可能怀孕的育龄妇女。

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