• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >The association between maternal use of spermicides, condoms, intra-uterine devices or progesterone and major structural birth defects.
【24h】

The association between maternal use of spermicides, condoms, intra-uterine devices or progesterone and major structural birth defects.

机译：孕产妇使用杀精剂，避孕套，宫内节育器或孕酮与主要结构性出生缺陷之间的关联。

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Birth defects occur in 1 of every 33 babies born in the United States, and are the leading cause of infant death. Mothers using contraceptives that become pregnant may continue to use their contraceptives after their first missed menstrual period, thus exposing their baby in utero to the contraceptive product. Progesterone is also sometimes prescribed during the first trimester of pregnancy to mothers with a history of miscarriages or infertility problems. To ensure the safety of these products, it is important to investigate whether there is an increased occurrence of babies born with birth defects to mothers using various contraceptive methods or progesterone in early pregnancy. Using data from the National Birth Defects Prevention Study (NBDPS), an ongoing multi-state, population based case-control study, this study assessed maternal exposures to IUDs, spermicides, condoms and progesterone in early pregnancy.;Progesterone used for threatened miscarriage during the first three months of pregnancy was associated with an increased occurrence of hypoplastic left heart (adjusted odds ratios (OR) 2.24, 95% CI 1.13-4.21), perimembranous ventricular septal defects (OR 1.64, 95% CI 1.10-2.41), septal associations (OR 2.52, 95% CI 1.45-4.24), esophageal atresia (OR 1.82, 95% CI 1.04-3.08), and hypospadias (OR 2.12, 95% CI 1.41-3.18). Mothers using progesterone for injectable contraception had increased (OR > 2.5), but insignificant odds ratios for anencephaly, septal associations, small intestinal atresias and omphalocel. Progesterone used for fertility was not associated with an increased occurrence of any birth defects examined.;Mothers using progesterone for fertility assistance and threatened miscarriage were very similar with respect to their demographics and pregnancy history. They also both reported similar types of progesterone. Thus, if progesterone was a causal risk factor for birth defects we would have expected to observe similar increases in risk among mothers using progesterone for both indications. Because we predominantly observed increased associations among mothers using progesterone for threatened miscarriage but not fertility assistance, it is possible the increased associations we observed were confounded by indication (i.e. progesterone was administered for vaginal bleeding which occurred as a sequelae to the formation of a congenital anomaly.;No significant increased associations were observed between maternal spermicide use during pregnancy and 26 of 27 types of structural malformations. While multiple statistical tests were performed we observed first trimester maternal spermicide use to be associated with a significant increased occurrence of perimembranous ventricular septal defects (OR 2.21, 95% CI 1.16-4.21). A decreased occurrence (OR 1.0) was observed for several categories of birth defects among mothers who conceived in the first cycle after discontinuing the use of spermicides (22 of 28) or male condoms (23 of 33).;Overall the percent of IUD use was similar between mothers of controls and mothers of all cases in aggregate (crude OR 1.05, 95% CI 0.61-1.84). Power was limited to detect significant associations between IUD use and birth defects, however mothers using an IUD in the month immediately prior to conception or during pregnancy were not associated with an increase of birth defects. Limb defects and amniotic band sequence previously reported to be associated with IUD use during pregnancy were not found to occur among any mothers reporting the use of an IUD during pregnancy.
机译：在美国，每33个婴儿中就有1个出生缺陷，这是婴儿死亡的主要原因。使用避孕药具的孕妇如果怀孕，可能会在第一次月经期后继续使用避孕药具，从而使子宫内的婴儿暴露于避孕药具下。有时在怀孕的前三个月中，对有流产或不孕症史的母亲开处方黄体酮。为了确保这些产品的安全，重要的是要调查在怀孕初期使用各种避孕方法或孕激素的母亲是否有先天缺陷的婴儿发生率增加。该研究使用了一项正在进行的多州，基于人群的病例对照研究-国家出生缺陷预防研究（NBDPS）的数据，评估了孕早期孕妇的宫内节育器，杀精子剂，避孕套和孕酮的暴露情况;孕激素在妊娠期间用于先兆流产。怀孕的前三个月与左心发育不良的发生率增加（校正比值比（OR）2.24，95％CI 1.13-4.21），膜周围室间隔缺损（OR 1.64，95％CI 1.10-2.41），间隔关联（OR 2.52，95％CI 1.45-4.24），食管闭锁（OR 1.82，95％CI 1.04-3.08）和尿道下裂（OR 2.12，95％CI 1.41-3.18）。使用黄体酮注射避孕的母亲有所增加（OR> 2.5），但无脑，中隔关联，小肠闭锁和全环相的优势比不明显。用于孕育的孕酮与所检查的任何出生缺陷的发生率均不相关。；使用孕酮辅助生育和威胁流产的母亲在人口统计学和妊娠史方面非常相似。他们还报告了类似类型的孕激素。因此，如果孕酮是出生缺陷的致病危险因素，那么我们预计使用孕激素作为两种适应症的母亲中的患病风险也会有类似的增加。因为我们主要观察到使用孕激素进行先兆流产而不是助孕的母亲之间的关联性增加，所以我们观察到的关联性增加可能与适应症混淆（即，孕激素用于阴道出血，这是先天性异常形成的后遗症。;在孕期使用母体杀精剂与27种结构性畸形中的26种之间，未发现显着增加的关联。尽管进行了多项统计测试，但我们观察到孕早期使用母体杀精剂与膜周围室间隔缺损的发生率显着增加有关（ OR 2.21，95％CI 1.16-4.21）。在停止使用杀精剂（28件中的22件）或男用避孕套（第28件）后的第一个周期受孕的母亲中，几类出生缺陷发生率降低（OR <1.0）。 33之23）。；总体而言，宫内节育器的使用百分比相似对照母亲和所有病例的母亲之间的总和（粗略OR 1.05，95％CI 0.61-1.84）。力量有限，无法发现宫内节育器使用与先天缺陷之间的显着关联，但是，在怀孕前一个月或怀孕期间使用宫内节育器的母亲与出生缺陷的增加无关。在任何报告过怀孕期间使用宫内节育器的母亲中，未发现先前报告与怀孕期间使用宫内节育器相关的肢体缺陷和羊膜带序列。

著录项

  • 作者

    Gallaway, Michael Shayne.;

  • 作者单位

    The University of Texas School of Public Health.;

  • 授予单位 The University of Texas School of Public Health.;
  • 学科 Health Sciences Obstetrics and Gynecology.;Health Sciences Public Health.;Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2008
  • 页码 137 p.
  • 总页数 137
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号