Birth defects after maternal exposure to corticosteroids: Prospective cohort study and meta-analysis of epidemiological studies

Laura Park-Wyllie, Paolo Mazzotta, Anne Pastuszak, Myla E. Moretti, Lizanne Beique, Laura Hunnisett, Mark H. Friesen, Sheila Jacobson, S. Kasapinovic, Debra Chang, Orna Diav-Citrin, David Chitayat, Irena Nulman, Thomas R. Einarson, Gideon Koren

פרסום מחקרי: פרסום בכתב עתמאמרביקורת עמיתים

798 ציטוטים ‏(Scopus)

תקציר

Background: Corticosteroids are first-line drugs for the treatment of a variety of conditions in women of childbearing age. Information regarding human pregnancy outcome with corticosteroids is limited. Methods: We collected prospectively and followed up 184 women exposed to prednisone in pregnancy and 188 pregnant women who were counseled by Motherisk for nonteratogenic exposure. The primary outcome was the rate of major birth defects. A meta-analysis of all epidemiological studies was conducted. The Mantel-Haenszel summary odds ratio was calculated for the pooled studies with 95% confidence intervals. A cumulative summary odds ratio was also calculated by combining studies in chronological order. Chi-squared for homogeneity was determined to establish the comparability of the studies. Results: In our prospective study, there was no statistical difference in the rate of major anomalies between the corticosteroid-exposed and control groups. In the meta-analysis, the Mantel-Haenszel summary odds ratio for major malformations with all cohort studies was 1.45 [95% Cl 0.80, 2.60] and 3.03 [95% Cl 1.08, 8.54] when Heinonen et al. ('77) was removed. This suggests a marginally increased risk of major malformations after first-trimester exposure to corticosteroids. In addition, summary odds ratio for case-control studies examining oral clefts was significant (3.35 [95% Cl 1.97, 5.69]). Conclusions: Although prednisone does not represent a major teratogenic risk in humans at therapeutic doses, it does increase by an order of 3.4-fold the risk of oral cleft, which is consistent with the existing animal studies. (C) 2000 Wiley-Liss, Inc.

שפה מקוריתאנגלית
עמודים (מ-עד)385-392
מספר עמודים8
כתב עתTeratology
כרך62
מספר גיליון6
מזהי עצם דיגיטלי (DOIs)
סטטוס פרסוםפורסם - 2000
פורסם באופן חיצוניכן

טביעת אצבע

להלן מוצגים תחומי המחקר של הפרסום 'Birth defects after maternal exposure to corticosteroids: Prospective cohort study and meta-analysis of epidemiological studies'. יחד הם יוצרים טביעת אצבע ייחודית.

פורמט ציטוט ביבליוגרפי