与瓦尔酸相关的解剖学,行为和认知产性:系统性审查
Kyle Valentino1,2,3, Kayla M Teopiz1, Angela T H Kwan1,4
1Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
CNS spectrums
|December 27, 2024
概括
怀孕期间暴露于酸 (VPA) 与儿童显著的解剖,行为和认知发育问题有关. 叶酸补充剂不会降低这些风险,支持在生育年龄的妇女中减少VPA的使用.
科学领域:
- 神经科学是一个神经科学.
- 发展生物学 发展生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 英国卫生当局建议不要在55岁以下的个体中使用酸 (VPA) 由于修订后的致性风险.
- 瓦尔酸是一种抗药,在怀孕期间具有已知的风险.
研究的目的:
- 系统地审查和综合现有关于益酸对解剖学,行为和认知害效应的研究.
- 评估叶酸补充剂在减轻与VPA相关的产性方面的有效性.
主要方法:
- 在多个数据库 (PubMed,Medline,Embase等) 进行了全面的文献搜索. 按照PRISMA的指导方针进行.
- 数据提取的重点是研究设计,参与者人口统计,原性结果 (解剖学,行为,认知) 和叶酸干预.
- 包括122项研究,分析了解剖学 (67),行为 (28) 和认知 (47) 产性,其中包括20项关于叶酸的研究.
主要成果:
- 产前VPA暴露与重大先天性形 (OR 2.47-9.30) 有显著的关联.
- 行为性原性包括自闭症 (OR 1.70-4.38),运动发育障碍 (OR 7.0) 和ADHD (OR 1.39) 的风险增加.
- 认知效应包括智力障碍和较低的智商 (HR 2.4-4.48);原性效应取决于剂量,比其他抗药更为明显. 叶酸补充剂没有显著降低风险.
结论:
- 瓦尔酸 (VPA) 与显著的解剖学,行为和认知毒性影响密切相关.
- 叶酸补充剂并不能有效降低与VPA相关的产性风险.
- 目前的证据支持建议尽量减少在生育年龄的妇女中VPA暴露.
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