外因性ホルモンの曝露と重大な発育不全のリスク

E J Lammer, J F Cordero

JAMA

|June 13, 1986

まとめ

妊娠初期に母親が性ホルモンを使用すると,乳児の食道縮のリスクが増加する可能性があります. しかし,避妊手段以外の性ホルモン曝露に関連する絶対リスクは依然として低い.

科学分野:

産婦人科と産婦人科を担当しています.
小児外科手術について
医学遺伝学医学遺伝学

背景:

妊娠初期における外来性ホルモンの母体による使用は,先天性変形と相関すると疑われています.
既存の研究は,潜在的なリンクを示しており,特定のホルモンタイプと不育児に関するさらなる調査が必要である.

研究の目的:

第1期間の性ホルモン曝露と乳児における先天性異常との関連性を調査する.
特定のホルモンタイプと,特定の発育不全との相関を特定する.

主な方法:

ダウン症候群または11の主要な発育不全の1つと診断された1,091人の乳児を対象にケース・コントロール研究が行われました.
他の不発症を持つ乳児は,それぞれの特定の不発症カテゴリーのコントロールとして使用されました.
分析は,最初の3ヶ月間の様々な性ホルモンに対する母親の暴露に焦点を当てた.

主要な成果:

食道縮症と性ホルモン (OR,2.84),プロゲスティン (OR,2.87),非特定性ホルモン (OR,2.99),ホルモン妊娠検査 (OR,2.81) に曝露するとの間に統計的に有意な関連性が見られた.
これらの関連性について,混同変数は特定されなかった.
異常形成と経口避妊薬の暴露との間に有意な関連性は見つかりませんでした.

結論:

非避妊用性ホルモン,特にプロゲスティンおよびホルモン妊娠検査への曝露は,食道縮のリスクの増加と関連しています.
観察された関連性にもかかわらず,そのような曝露による食道縮の絶対的なリスクは低く,約1万生児につき約6人と見積もられています.
最初の3ヶ月間に経口避妊薬の使用は,研究された不発症と有意な関連性を示さなかった.

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