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Int J Epidemiol:对乙酰氨基酚可能不再是妊娠期安全药物

2016-07-05 Seven L 译 MedSci原创

孕期可以使用的药物本来就很少,再一细分到止痛药,更是少的可怜;还好,价廉物美的家庭必备药对乙酰氨基酚被认为是安全的。美国约有65%的准妈妈使用这种药物。遗憾的是,一项新的研究表明,产前暴露于对乙酰氨基酚可能与后代的自闭症和注意缺陷多动障碍(ADHD)有关,至此以后它可能不那么安全了。西班牙巴塞罗那的环境流行病学研究中心的研究人员Claudia Avella-Garcia和同事招募了2644名妊娠1

孕期可以使用的药物本来就很少,再一细分到止痛药,更是少的可怜;还好,价廉物美的家庭必备药对乙酰氨基酚被认为是安全的。美国约有65%的准妈妈使用这种药物。

遗憾的是,一项新的研究表明,产前暴露于对乙酰氨基酚可能与后代的自闭症和注意缺陷多动障碍(ADHD)有关,至此以后它可能不那么安全了。

西班牙巴塞罗那的环境流行病学研究中心的研究人员Claudia Avella-Garcia和同事招募了2644名妊娠12-32周的准妈妈参加他们的研究。妇女完成了一份问卷调查,她们被问及是否在怀孕前一个月内或在怀孕期间使用对乙酰氨基酚。此外还评估了女性该药物的使用频率;由于母亲无法回忆起,所以不能评估确切剂量。

随后88%的女性的后代在1岁时采用贝利婴幼儿发展量表(BSID)评估儿童神经心理发育;79.9%的后代在5岁时通过大量的测试,包括麦卡锡儿童的能力量表(MCSA)和儿童自闭症光谱测试(CAST),进行了评估。

研究人员发现,43%的1岁评估儿童和41%的5岁评估儿童,其母亲在妊娠32周之前使用过对乙酰氨基酚。与在怀孕期间没有服用对乙酰氨基酚的母亲的孩子相比,后代在5岁时更有可能(30%)发生注意力障碍(自闭症和ADHD的主要症状)。此外,孩子出生前暴露于对乙酰氨基酚也更可能在5岁时有多动和冲动症状。持续暴露于药物的后代在注意力、冲动和视觉处理速度测试中表现的很糟糕。

针对男孩后代,研究者发现,产前对乙酰氨基酚暴露的男孩更可能出现自闭症的临床症状;持续暴露于药物会导致症状发病率增加。

研究小组说,这一发现可以解释为什么男孩比女孩更容易患自闭症。

“男性的大脑可能在生命早期更容易受到有害的影响,”Avella-Garcia说。“性别差异研究结果表明,男性大脑可能对雄激素的内分泌紊乱更敏感,或许能够解释这其中的关联。”

总体而言,研究结果表明,在子宫内暴露于对乙酰氨基酚,可能会导致后代有更大的自闭症或ADHD症状风险。

原始出处:


Acetaminophen use in pregnancy and neurodevelopment: attention function and autism spectrum symptoms, Claudia Avella-Garcia et al., International Journal of Epidemiology, doi: 10.1093/ije/dyw115, published online 28 June 2016.

Acetaminophen use in pregnancy linked to autism, ADHD in offspring.

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encodeId=10e09205572, content=可能, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3781729882, createdName=WEIXINa82df6bc, createdTime=Tue Jul 05 22:31:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91992, encodeId=e29c919926f, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91993, encodeId=5ea791993b8, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-09-10 ylzr123

    点个赞!好文有待探究。

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 17:00:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250993, encodeId=3bb71250993e0, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Thu Jul 07 05:24:00 CST 2016, time=2016-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321772, encodeId=26c81321e7247, content=<a href='/topic/show?id=818246618a4' target=_blank style='color:#2F92EE;'>#对乙酰氨基酚#</a>, 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content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-08-27 ylzr123

    好文,值得学习,赞一个。

    0

  5. 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  6. 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  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 17:00:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250993, encodeId=3bb71250993e0, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Thu Jul 07 05:24:00 CST 2016, time=2016-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321772, encodeId=26c81321e7247, content=<a href='/topic/show?id=818246618a4' target=_blank style='color:#2F92EE;'>#对乙酰氨基酚#</a>, 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encodeId=10e09205572, content=可能, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3781729882, createdName=WEIXINa82df6bc, createdTime=Tue Jul 05 22:31:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91992, encodeId=e29c919926f, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91993, encodeId=5ea791993b8, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-07-06 医路开来

    希望抓紧时间研究妊娠期的安全药物

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 17:00:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250993, encodeId=3bb71250993e0, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Thu Jul 07 05:24:00 CST 2016, time=2016-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321772, encodeId=26c81321e7247, content=<a href='/topic/show?id=818246618a4' target=_blank style='color:#2F92EE;'>#对乙酰氨基酚#</a>, 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encodeId=10e09205572, content=可能, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3781729882, createdName=WEIXINa82df6bc, createdTime=Tue Jul 05 22:31:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91992, encodeId=e29c919926f, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91993, encodeId=5ea791993b8, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-07-05 WEIXINa82df6bc

    可能

    0

  9. 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encodeId=10e09205572, content=可能, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3781729882, createdName=WEIXINa82df6bc, createdTime=Tue Jul 05 22:31:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91992, encodeId=e29c919926f, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91993, encodeId=5ea791993b8, content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-07-05 jaysppr

    好文章,学习学习!

    0

  10. 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content=好文章,学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Tue Jul 05 16:38:00 CST 2016, time=2016-07-05, status=1, ipAttribution=)]
    2016-07-05 jaysppr

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