孕期暴露于母体全身葡萄皮质类药物和儿童患CKD风险
You-Lin Tain1, Lung-Chih Li2, Hsiao-Ching Kuo3
1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.
概括
孕妇在怀孕期间使用全身葡萄糖皮质类药物与儿童患慢性病 (CKD) 的风险增加1.7倍有关. 这种关联在较高剂量,第二季度暴露和早产时更为强烈.
科学领域:
- 儿科脏病学 儿科脏病学
- 产科和妇科 产科和妇科
- 药学流行病学 药学流行病学
背景情况:
- 对于儿童的产前葡萄糖皮质激素暴露对健康的影响仍然不完全理解.
- 系统性皮质糖类药物在怀孕期间经常被处方,需要检查它们对后代的长期影响.
- 儿童慢性病 (CKD) 是一个严重的健康问题,可能会导致终身后果.
研究的目的:
- 研究孕期母体全身葡萄糖皮质激素暴露与儿童患慢性病 (CKD) 的后续风险之间的关联.
- 为了确定特定的暴露条件,如妊娠时间和剂量,这可能会改变这种关联.
主要方法:
- 通过使用台湾最大的医疗保健系统 (2004-2018) 的数据进行了一项回顾性队列研究.
- 系统性皮质糖类药物的孕产妇处方被用作孕期暴露的代理.
- 考克斯的比例危险模型与治疗权重的逆概率被用于评估与10年多的儿童CKD事件的关联.
主要成果:
- 孕期暴露于系统性皮质糖类药物与儿童CKD风险增加显著相关 (调整后危险比率[AHR],1.69).
- 在包括早产婴儿 (<37周妊娠年龄;AHR,2.38),男性 (AHR,1.89),第二个月的暴露 (AHR,6.70) 和较高的累积剂量 (>24mg皮等效;AHR,1.91) 的子组中观察到高风险.
结论:
- 孕期暴露于全身葡萄糖皮质类药物与儿童病发病率增加有关.
- 这些发现表明,临床医生在怀孕期间处方全身葡萄皮质激素时,应仔细考虑风险和益处.
- 需要进一步的研究来证实这些关联并阐明潜在的机制.
更多相关视频
相关概念视频
01:20Pathophysiology of Diabetes
927
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
927
01:27Adrenal Gland Disorders
1.5K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.5K
01:22Diabetes Mellitus: Type 2 and Gestational
2.4K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.4K
01:17Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
01:29Pulmonary Tuberculosis I
242
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
242
01:07Teratogenicity
2.4K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.4K