父亲暴露于常规和生物DMARDs对新生儿结局的影响
Yu-Hsuan Joni Shao1,2,3, Tzu-Tung Kuo3, Wei-Hao Wang1,4
1Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
父亲使用某些自身免疫药物,如环素和阿扎西奥普林,可能会增加不良分娩结果的风险,如早产和先天异常. 甲托雷克萨特没有显示任何不良影响,但在计划怀孕之前,进一步的药物安全研究至关重要.
科学领域:
- 生殖医学 生殖医学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 父亲接触自身免疫性风湿性疾病 (AIRD) 药物及其对出生结果的影响尚未得到充分证实.
- 了解与传统合成药物 (csDMARDs),生物药物 (bDMARDs) 和向合成药物 (tsDMARDs) 相关的风险至关重要.
研究的目的:
- 调查父亲暴露于csDMARDs,bDMARDs或tsDMARDs和不良分娩结果之间的关联.
- 专门检查妊娠年龄较小的婴儿,早产和先天异常的风险.
主要方法:
- 基于人口的出生队列研究,使用台湾的健康和出生登记数据 (2004-2020年).
- 鉴定了患有AIRD的父亲,并分析了对免疫抑制剂或生物药物 (38-60周前的分娩) 的孕前暴露.
- 使用治疗权重的逆概率 (IPTW) 逻辑回归来评估药物特定风险.
主要成果:
- 对42,493例分娩的分析显示,14.3%的父亲接触了相关药物.
- 甲托雷克萨特没有显示出与出生结果的不良关联.
- 环素与妊娠年龄 (VSGA) 非常小和早产的风险增加有关.
- 阿扎西奥普林,非TNFi生物制剂和tsDMARDs与更高的出生缺陷风险有关.
- 结合cDMARDs与bDMARDs/tsDMARDs增加了出生缺陷的风险,包括心血管异常,口腔裂和肌肉骨缺陷.
结论:
- 父亲暴露在某些免疫抑制剂和生物药物中,除了甲状腺素,可能与不良出生结果有关.
- 强调需要进一步研究计划怀孕的男性患者药物安全性.
- 强调在怀孕前谨慎的药物管理和咨询.
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