怀孕前接触计算机断层扫描和怀孕损失和先天异常的风险:基于人口的队列研究
Camille Simard1, Longdi Fu2, Tomi Odugbemi2
1Department of Medicine, Jewish General Hospital, and Lady Davis Institute for Medical Research, Montreal, Quebec, Canada (C.S., V.T.).
Annals of internal medicine
|September 8, 2025
概括
怀孕前的计算机断层扫描 (CT) 扫描可能会增加流产和出生缺陷的风险. 需要进一步的研究来理解因果关系,并考虑替代的成像方法.
科学领域:
- 放射学和成像学 放射学和成像学
- 生殖健康 生殖健康
- 医学诊断 医学诊断 医学诊断
背景情况:
- 动物研究表明,计算机断层扫描 (CT) 的电离辐射可以损害卵巢毛囊并引起突变.
- 预孕CT成像对未来怀孕的潜在风险在很大程度上是未知的.
研究的目的:
- 评估预孕CT电离辐射暴露与自发妊娠流产风险之间的关联.
- 为了评估在受孕前母亲暴露于CT扫描后后代的先天异常风险.
主要方法:
- 在加拿大安大略省进行了一项以人口为基础的观察性研究,分析了1992年至2023年期间5,142,339例已确认怀孕和3,451,968例活产的数据.
- 暴露被定义为怀孕前四周内CT扫描的累积数量.
- 结局包括自发流产 (流产,宫外妊娠,死产) 和在生命的第一年内诊断的先天性异常.
主要成果:
- 随着怀孕前CT扫描的数量增加 (调整后危险比率从1.08到1.19不等) 观察到自发妊娠损失率的增加.
- 同样,随着CT扫描暴露的增加,先天性异常率也增加了 (调整后的危险比率从1.06到1.15)
- 与头部CT相关的风险并不总是低于腹部,骨盆或脊椎下部CT的风险.
结论:
- 怀孕前CT成像暴露可能与自发妊娠损失和先天异常的风险增加有关.
- 潜在的因果机制需要进一步调查.
- 在临床上适当时,建议考虑替代的成像方法.
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