在子宫中暴露于皮质类固醇和B2-上腺激动剂的后代中神经发育结果
Abir Nagata1,2, Toshio Masumoto3, Hidekazu Nishigori4
1Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan.
JAMA network open
|October 24, 2023
概括
在子宫内,在怀孕期间暴露于皮质类固醇和β2-上腺激动剂并没有显示与后代神经发育迟缓的关联. 这些喘药物似乎对孕妇和他们的孩子都是安全的.
科学领域:
- 生殖医学和发育儿科.
- 药理学和病理学学.
- 公共卫生和流行病学.
背景情况:
- 皮质类固醇和β2-上腺激动剂经常被处方用于孕妇的喘管理.
- 对这些药物的产前暴露对后代神经发育的影响仍然不完全理解.
研究的目的:
- 检查在子宫内暴露于皮质类固醇和β2-上腺激动剂和神经发育里程碑的时间之间的关系,在3岁以下的儿童中.
主要方法:
- 一项大型队列研究利用了日本环境和儿童研究 (JECS) 的数据.
- 包括了91,460对母婴.
- 通过使用年龄和阶段问卷 (ASQ-3) 在6至36个月的多个时间点评估后代的神经发育 (沟通,运动技能,解决问题,个人社会技能).
主要成果:
- 在产前皮质类固醇暴露 (怀孕早期,中期到晚期或整个怀孕期间) 与五个评估的神经发育里程碑中的任何一个之间没有显著的关联.
- 在怀孕早期暴露于β2-上腺激动剂和神经发育结果之间没有发现任何关联.
- 在怀孕中期和晚期暴露于β2-上腺激动剂和延迟的个人社交技能之间发现了边际关联 (aOR,1.48;95% CI,1.01-2.32).
结论:
- 这项研究表明,无论暴露时间如何,产前暴露于皮质类固醇和β2-上腺激动剂与后代的不良神经发育结果无关.
- 研究结果支持这些常用的喘药在怀孕期间对母婴健康的安全性.
- 用更大的样本规模进行进一步的研究可能是有必要的,以证实观察到的与个人社会技能的边际关联.
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