抗発作薬に対する父親の暴露と子孫のアウトカム:観察研究の体系的レビューとメタ解析
Vivia Ochmann1, Christos Gkoltsos1, Chiara Gastaldon2
1Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
Expert opinion on drug metabolism & toxicology
|September 1, 2025
まとめ
妊娠中の父親による抗発作治療は,子宮に重大な先天性異常や神経発達障害のリスクを増加させない. 研究結果の異質性に対処するためにさらなる研究が必要である.
科学分野:
- 生殖医学
- 小児神経学
- 薬理学について
背景:
- 妊娠中の抗発作薬 (ASM) に父親の曝露は懸念が高まっている.
- 子孫に対する潜在的なリスクを理解することは 生殖カウンセリングに不可欠です
研究 の 目的:
- 妊娠時に父親によるASM使用と子孫への悪影響との関連を評価する.
- 主要な先天性欠陥や神経発達障害に関する既存の証拠を統合する.
主な方法:
- 6つの研究 (n=17,974) の体系的レビューとメタ分析.
- ニューカッスル・オタワスケールによる品質評価
- 研究の設計と品質への影響を評価するために,サブグループと感受性分析が行われました.
主要な成果:
- 主要な先天性異常 (OR=1.22,95%CI=0. 55~2. 68) または神経発達障害 (OR=1.21,95%CI=0. 73~1. 99) のリスクにおいて,父親のASMにさらされた子孫において有意な差異はありません.
- 両方のアウトカムにおいて,著しい異質性が見られた (I2 > 90%).
- 神経発達障害の確率比は,コホート研究と比較して横断的に高かった.
結論:
- 妊娠中に父親のASM治療による不良結果のリスクは増加していない.
- 本質的な異質性は,発見の慎重な解釈を必要とします.
- これらの結果を裏付けるには,さらに質の高い研究が必要である.
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