Källén B, Karlsson P, Lundell M, Wallgren A, Holm L E
Tornblad Institute, University of Lund, Sweden.
Radiat Res. 1998 Feb;149(2):202-8.
The possible impact of early gonadal irradiation on the results of future pregnancies is unclear. This study is based on the progeny of 17,393 women who were treated with irradiation for skin hemangiomas at the age of 18 months or less. The mean ovarian dose was 6 cGy, and the maximum was 8.55 Gy. Using Swedish central health registers, the outcome of delivery was studied in these women; 19,494 infants born were identified. The treated women deviated from the general population by having a longer education and by smoking less. This may explain a reduced risk for low birth weight and preterm birth (not related to radiation dose). Women with ovarian doses greater than 1 cGy had fewer infants than women with a lower ovarian dose. An excess of perinatal deaths was evident as well as a slight excess in the rate of malformation, but neither was related to dose. There was a statistically significant trend of an increasing rate of neural tube defects with ovarian dose, possibly a chance result of multiple statistical testing. Cleft lip/palate occurred at levels significantly below expectation. No increase in the rate of infants with Down syndrome or in childhood malignancies was detected. No major adverse results in outcome of delivery were seen after ovarian irradiation in childhood with the possible exception of neural tube defects.
早期性腺照射对未来妊娠结果的可能影响尚不清楚。本研究基于17393名18个月及以下因皮肤血管瘤接受照射治疗的女性的后代。卵巢平均剂量为6厘戈瑞，最大剂量为8.55戈瑞。利用瑞典中央健康登记系统，对这些女性的分娩结局进行了研究；共识别出19494名出生婴儿。接受治疗的女性与普通人群的差异在于受教育程度更高且吸烟较少。这可能解释了低出生体重和早产风险降低的原因（与辐射剂量无关）。卵巢剂量大于1厘戈瑞的女性所生婴儿比卵巢剂量较低的女性少。围产期死亡明显过多，畸形率也略有增加，但两者均与剂量无关。神经管缺陷发生率随卵巢剂量增加存在统计学显著趋势，这可能是多次统计检验的偶然结果。唇腭裂发生率明显低于预期水平。未检测到唐氏综合征婴儿或儿童期恶性肿瘤发生率增加。儿童期卵巢照射后，除神经管缺陷可能外，未观察到分娩结局的重大不良结果。
