产前暴露于大麻和重大结构性出生缺陷的风险:系统性审查和元分析
Erin Delker1, Shana Hayes, Ann E Kelly
1Department of Pediatrics, University of California, San Diego, San Diego, California.
Obstetrics and gynecology
|July 20, 2023
概括
这次元分析发现了不一致的证据,将产前大麻暴露与重大结构性出生缺陷联系起来. 虽然观察到一些关联,但在调整后,大多数都减弱了, notable exceptions for Ebstein anomaly and gastroschisis 是一个显著的例外.
科学领域:
- 生殖健康 生殖健康
- 发育毒理学 发展毒理学
- 流行病学 流行病学
背景情况:
- 产前接触大麻是一个日益严重的公共卫生问题.
- 了解母亲使用大麻与婴儿后果之间的关联至关重要.
- 关于结构性出生缺陷和产前大麻暴露的现有研究是多样化的.
研究的目的:
- 进行观察性研究的系统审查和元分析.
- 检查产前大麻暴露与重大结构性出生缺陷之间的关联.
- 综合有关特定出生缺陷类型的证据.
主要方法:
- 搜索了多个数据库,包括PubMed,EMBASE和谷歌学者.
- 包括1968-2021年的观察性研究,不包括病例报告和同时使用药物的研究.
- 根据解剖学群体对出生缺陷的关联度进行了元分析,重点关注调整后的几率比率.
主要成果:
- 分析了23项研究,发现非特异性先天性异常的合并几率比为1.33.
- 大多数聚合协会在调整后减弱,表明潜在的混因素.
- 埃布斯坦异常 (aOR 2.19) 和胃 (aOR 2.50) 显示风险估计增加,但没有减弱.
结论:
- 关于产前大麻暴露与出生缺陷之间存在普遍关联的证据是不一致的.
- 具体的异常,如埃布斯坦异常和胃,需要进一步调查.
- 在许多研究中,高异质性和低质量的证据需要谨慎的解释.
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