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La exposición exógena a las hormonas sexuales y el riesgo de malformaciones mayores
JAMA
|June 13, 1986
Resumen
El uso materno de hormonas sexuales en el embarazo temprano puede aumentar el riesgo de atresia esofágica en los bebés. Sin embargo, el riesgo absoluto asociado con la exposición a las hormonas sexuales sin anticonceptivos sigue siendo bajo.
Área de la Ciencia:
- Obstetricia y Ginecología.
- Cirugía pediátrica en cirugía pediátrica.
- Genética médica La genética médica.
Sus antecedentes:
- Se sospecha que el uso materno de hormonas sexuales exógenas durante el embarazo temprano se correlaciona con malformaciones congénitas.
- Las investigaciones existentes indican un vínculo potencial, lo que requiere una mayor investigación sobre tipos específicos de hormonas y malformaciones.
Objetivo del estudio:
- Investigar la asociación entre la exposición a las hormonas sexuales en el primer trimestre y las malformaciones congénitas en los bebés.
- Para identificar tipos específicos de hormonas y su correlación con malformaciones particulares.
Principales métodos:
- Se realizó un estudio de caso-control en el que participaron 1.091 bebés diagnosticados con síndrome de Down o una de las 11 malformaciones mayores.
- Los bebés con otras malformaciones sirvieron como controles para cada categoría específica de malformación.
- El análisis se centró en la exposición materna durante el primer trimestre a varias hormonas sexuales.
Principales resultados:
- Se observó una asociación estadísticamente significativa entre la atresia esofágica y la exposición a cualquier hormona sexual (OR, 2.84), progestágenos (OR, 2.87), hormonas sexuales no especificadas (OR, 2.99) y pruebas hormonales de embarazo (OR, 2.81).
- No se identificaron variables de confusión para estas asociaciones.
- No se encontró una asociación significativa entre cualquier malformación y la exposición a anticonceptivos orales.
Conclusiones:
- La exposición a las hormonas sexuales no anticonceptivas, particularmente a los progestágenos y las pruebas hormonales de embarazo, se asocia con un mayor riesgo de atresia esofágica.
- A pesar de la asociación observada, el riesgo absoluto de atresia esofágica por tal exposición es bajo, estimado en aproximadamente seis por cada 10.000 nacidos vivos.
- El uso de anticonceptivos orales durante el primer trimestre no mostró una asociación significativa con las malformaciones estudiadas.
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