怀孕期间使用抗发作药物和儿童的神经发育结果
Paul Madley-Dowd1,2,3, Viktor H Ahlqvist4,5, Harriet Forbes6,7
1Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. p.madley-dowd@bristol.ac.uk.
Nature communications
|November 15, 2024
概括
怀孕期间的瓦尔酸和其他抗发作药物 (ASM) 可能会增加儿童神经发育障碍的风险. 拉莫特里金的风险证据较少,这表明孕妇可能有更安全的替代品.
科学领域:
- 神经科学是一个神经科学.
- 发育儿科 发育儿科
- 药理学 药理学是指药理学的学科.
背景情况:
- 怀孕期间的瓦尔酸的致性已知.
- 关于其他抗发作药物 (ASM) 在怀孕期间的长期安全性的数据有限.
- 了解与ASM相关的风险对于母婴健康至关重要.
研究的目的:
- 调查各种ASM产前暴露与儿童神经发育诊断之间的关联.
- 为了比较自闭症,智力障碍和ADHD的风险,暴露于不同的ASM后.
主要方法:
- 使用了英国初级保健数据和瑞典国家注册表.
- 创建了一个超过300万儿童的大队伍,其中包括近17,500名在产前接触ASM的儿童.
- 采用了强大的统计分析来比较暴露和未暴露组之间的神经发育结果.
主要成果:
- 产前瓦尔酸盐暴露与更高的自闭症,智力障碍和ADHD率有关.
- 托皮拉暴露增加了智力障碍的可能性2.5倍.
- 卡巴马西平暴露与自闭症风险增加1.25倍和智力障碍风险增加1.30倍有关.
- 拉莫特里金暴露与增加神经发育诊断的相关性很小.
结论:
- 怀孕期间使用瓦尔酸盐,托皮拉酸盐和卡巴马泽平可能与神经发育障碍的风险增加有关.
- 对于这些结果,拉莫特里金似乎具有相对更好的安全性.
- 在怀孕前考虑替代性,更安全的ASM在临床上可行时是合理的.
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