摘要
目的探讨母孕期使用抗甲状腺药物对后代先天畸形发生风险的影响。方法检索PubMed、EMBASE、 Cochrane Library、 Ovid、中国知网、维普和万方等数据库中关于母孕期使用抗甲状腺药物对后代先天畸形风险的相关研究,检索时限均为从建库起至2018年4月1日。采用RevMan 5.3软件进行Meta分析,探讨两者之间的关系。结果共纳入15项研究, 21 167名孕妇在孕期使用不同的抗甲状腺药物, Meta分析结果显示,甲亢孕妇妊娠早期使用抗甲状腺药物[甲巯咪唑(MMI)/卡比马唑(CMZ)或丙硫氧嘧啶(PTU)或MMI/CMZ+PTU](暴露组)均比无甲亢孕妇(对照组)及妊娠期未使用抗甲状腺药物的甲亢孕妇(未用药组)后代的先天畸形风险明显升高(P <0.05); MMI/CMZ组后代发生先天畸形的风险显著高于PTU组(P <0.05); MMI/CMZ+PTU组与MMI/CMZ组、 PTU组相比,后代发生先天畸形的风险无显著差异(P≥0.05)。结论妊娠期甲亢患者使用抗甲状腺药物会使后代发生先天畸形的风险升高,应权衡利弊,谨慎用药。
AIM To determine the effects of exposure to different antithyroid drugs during pregnancy on the incidence of congenital malformations in offspring.METHODS The PubMed,EMBASE,Cochrane Library and Ovid,CNKI,VIP,and Wangfan databases were searched for correlational studies on the association between the use of antithyroid drugs (ATDs)during pregnancy and the incidence of congenital malformations in offspring.The retrieval time was from inception to April 1,2018.A meta-analysis was performed to determine the incidence of congenital pregnancy through RevMan malformations in offspri 5.3.RESULTS Fifteen ng after exposure to different antithyroid drugs during studies involving 21167 pregnant women exposed to different ATDs during pregnancy were included in this meta-analysis.The incidence of congenital malformations in offspring were significantly increased in the ATDs (methimazole (MMI)/carbimazole (CMZ)or propylthiouracil (PTU)or MMI/CMZ +PTU)exposure group during the first trimester compared with the euthyroid pregnant women (control group)and the pregnant women with hyperthyroidism without exposure to any ATDs during pregnancy (No ATD group)(P <0.05).The risk of congenital malformations was significantly higher in the MMI/CMZ exposure group than the PTU exposure group (P <0.05).However,there were no significant difference in the incidence of congenital malformations in the MMI/CMZ +PTU exposure group compared with the MMI/CMZ exposure group or PTU exposure group (P ≥0.05).CONCLUSION The risk of congenital malformations in offspring was increased in pregnant women with hyperthyroidism when exposing to ATDs.The advantages and disadvantages of ATDs administration-should be weighted and the safety must be considerate.
作者
颜莉
余春飞
郑天银
刘彬
YAN Li;YU Chun-fei;ZHENG Tian-yin;LIU Bin(Department of Pharmacy &Ministry of Education Key Laboratory of Child Development and Disorders,Children's Hospital of Chongqing Medical University,CHONGQING 400014,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2018年第11期628-639,共12页
Chinese Journal of New Drugs and Clinical Remedies
