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患有慢性炎症性关节炎的父母使用抗风湿疗法产生的后代的神经发育结果:范围审查
Eugenia Y Chock1, Sovit Dahal2, Alyssa A Grimshaw3
1Section of Rheumatology, Yale School of Medicine, New Haven, CT, USA.
Seminars in arthritis and rheumatism
|June 9, 2023
概括
大多数患有类风湿性疾病的妇女在怀孕期间停止服用药物. 一些治疗方法,如NSAIDs,TNF抑制剂和甲铁沙,并没有增加后代的神经发育风险. 皮质类固醇可能构成ADHD的风险.
科学领域:
- 类风湿病学 类风湿病学
- 产科 产科 产科 产科 产科
- 儿科 儿科 儿科
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于安全问题,患有风湿性疾病的妇女在怀孕期间经常停止抗风湿疗法.
- 这一决定影响了疾病管理和母亲/胎儿的福祉.
研究的目的:
- 对患有慢性炎症性关节炎的父母在受孕或怀孕期间使用抗风湿疗法时出现不良后代神经发育结果的风险进行范围审查.
- 综合现有关于该群体药物安全性的证据.
主要方法:
- 根据PRISMA指导方针先行设计了一个范围审查协议.
- 在2023年1月,在多个数据库 (Cochrane Library,Embase,Google Scholar,Medline,Web of Science) 进行了详尽的文献搜索.
- 包括六项研究,数据提取和独立审查员的批判性评估.
主要成果:
- 在怀孕早期使用非类固醇抗炎药物 (NSAID),瘤坏死因子α (TNFα) 抑制剂和甲状腺素似乎不会增加后代神经发育不良结果的风险.
- 怀孕期间使用皮质类固醇与子女注意力缺陷多动症障碍 (ADHD) 的潜在风险增加有关.
结论:
- 某些抗风湿疗法在怀孕期间可能是安全的,因为它们会影响后代的神经发育.
- 需要进一步的研究来探索影响慢性炎症性关节炎的父母长期后代健康的混因素.
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