Sylvester G C, Khoury M J, Lu X, Erickson J D
Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333.
Am J Public Health. 1994 Nov;84(11):1757-60. doi: 10.2105/ajph.84.11.1757.
Although up to 2% of women undergo surgery during pregnancy, teratogenic effects of general anesthesia have not been adequately studied. Recently, an association between first-trimester operations and central nervous system defects has been described. This issue was explored in a population-based case-control study.
Case patients included live-born and stillborn infants with central nervous system defects born to residents of metropolitan Atlanta, Ga, between 1968 and 1980. Control patients included normal babies frequency matched to case patients by race, birth hospital, and period of birth. Conditional logistic regression analysis was used to adjust for potential confounding factors.
Of 694 mothers of infants with central nervous system defects, 12 reported first-trimester anesthesia exposure; 34 of 2984 control mothers reported such exposure (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.8, 3.3). A striking association was observed between reported anesthesia exposure and hydrocephalus with another major defect (OR = 9.6, 95% CI = 3.8, 24.6). The strongest association was that of anesthesia exposure with hydrocephalus and eye defects (OR = 39.6, 95% CI = 7.5, 209.2).
An increased risk of hydrocephalus with other defects was found among offspring of mothers with reported first-trimester anesthesia. Further studies are needed to explore the possible teratogenic effects of general anesthesia.
尽管高达2%的女性在孕期接受手术，但全身麻醉的致畸作用尚未得到充分研究。最近，有人描述了孕早期手术与中枢神经系统缺陷之间的关联。在一项基于人群的病例对照研究中探讨了这个问题。
病例患者包括1968年至1980年间出生于佐治亚州亚特兰大大都市的患有中枢神经系统缺陷的活产和死产婴儿。对照患者包括按种族、出生医院和出生时期与病例患者频率匹配的正常婴儿。采用条件逻辑回归分析来调整潜在的混杂因素。
在694名患有中枢神经系统缺陷婴儿的母亲中，有12名报告在孕早期有麻醉暴露；在2984名对照母亲中有34名报告有此类暴露（优势比[OR]=1.7，95%置信区间[CI]=0.8，3.3）。在报告的麻醉暴露与脑积水合并另一种主要缺陷之间观察到显著关联（OR=9.6，95%CI=3.8，24.6）。最强的关联是麻醉暴露与脑积水和眼部缺陷之间的关联（OR=39.6，95%CI=7.5，209.2）。
在报告孕早期有麻醉暴露的母亲的后代中，发现脑积水合并其他缺陷的风险增加。需要进一步研究来探讨全身麻醉可能的致畸作用。
