胎児の生涯中のベンゾジアゼピンへの曝露の影響
1Department of Clinical Pharmacology, Karolinska Institute, Huddinge Hospital, Sweden.
Lancet (London, England)
|September 19, 1992
まとめ
妊娠中のベンゾジアゼピンの高用量は,先天性欠陥と関連している可能性があります. しかし,この関連性は,母親の頻度の高いアルコールと薬物乱用によって混乱しており,ベンゾジアゼピン暴露のみによるものではないことを示唆しています.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 小児科は小児科です.
- 薬理学 薬理学とは
背景:
- 以前の報告では,妊娠中のベンゾジアゼピンの高用量使用と,変形性障害や精神障害などの胎児への不良結果との関連が示唆されていた.
- ベンゾジアゼピンのテロゲン性可能性は,特に混同要因を考慮して,さらなる調査を必要とします.
研究 の 目的:
- 妊娠中のベンゾジアゼピン使用と胎児の結果との関連を調査する.
- 高用量のベンゾジアゼピンに曝された子孫における先天性異常およびその他の有害な結果の発生率を評価する.
主な方法:
- 1980年から1983年にかけて,メディケイド (米国公共医療保険) に登録された10万4,000人の妊娠を対象とした大規模なコホート研究.
- 胎児のアウトカムは,出産後6~9年までの子孫の健康に関する主張データを用いて評価されました.
- ベンゾジアゼピンの処方箋が10件以上あった80例の妊娠に注目し,同時発生の薬物乱用と医療利用を分析した.
主要な成果:
- ベンゾジアゼピンを大量に使用した80例の妊娠のうち,子宮内死亡3例と先天性異常 (新生児死亡を示唆する) を有する乳児2例が特定されました.
- 64人の生存した子供のうち,6人の診断はテロゲン異常と一致していた.
- 母親の記録は,重度の医療使用,頻繁なアルコール,薬物乱用を示し,ベンゾジアゼピン効果の隔離を複雑にしました.
結論:
- 妊婦がベンゾジアゼピンを大量に使用した妊娠において,高レベルのテロゲニシティが観察されました.
- 観察されたテラトジェニシティは,複数のアルコールおよび物質の曝露とともに発生し,これらの要因がベンゾジアゼピン単独ではなく,異常を混同または引き起こす可能性があることを示しています.
- ベンゾジアゼピンの効果と妊娠中の他の物質の使用を区別するためにさらなる研究が必要です.
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