Piper J M, Mitchel E F, Ray W A
Department of Preventive Medicine, Vanderbilt University, Nashville, Tennessee.
Obstet Gynecol. 1993 Sep;82(3):348-52.
To determine whether the use of metronidazole by pregnant women increases the risk of birth defects in the offspring.
Two cohorts of pregnant women who delivered live-born or stillborn infants between January 1, 1983 and December 31, 1988 were identified from the Tennessee Medicaid enrollment files. The exposed cohort consisted of 1387 women who filled a prescription for metronidazole between 30 days before and 120 days after the onset of their last normal menstrual period. The unexposed cohort consisted of 1387 comparable women who did not fill a prescription for metronidazole during the same time. Medical records for 94% of the offspring of both study cohorts were then reviewed to ascertain the occurrence of birth defects.
Pregnancy outcomes were similar for the exposed and unexposed cohort members. There was no excess of overall birth defect occurrence in the offspring of exposed women (risk ratio 1.2, 95% confidence interval 0.9-1.6), nor could an excess risk be detected for any category of birth defects.
This study provides no evidence that prenatal use of metronidazole increases the risk of overall birth defect occurrence.
确定孕妇使用甲硝唑是否会增加其后代出生缺陷的风险。
从田纳西州医疗补助登记档案中识别出两组在1983年1月1日至1988年12月31日期间分娩活产或死产婴儿的孕妇队列。暴露队列由1387名妇女组成，她们在末次正常月经开始前30天至开始后120天内开具了甲硝唑处方。未暴露队列由1387名可比妇女组成，她们在同一时期未开具甲硝唑处方。然后对两个研究队列中94%的后代的医疗记录进行审查，以确定出生缺陷的发生情况。
暴露队列和未暴露队列成员的妊娠结局相似。暴露组妇女的后代中总体出生缺陷发生率没有过高（风险比1.2，95%置信区间0.9 - 1.6），任何一类出生缺陷也未检测到过高风险。
本研究没有提供证据表明产前使用甲硝唑会增加总体出生缺陷发生的风险。
