Exposure to Non-Steroidal Anti-Inflammatory Drugs during Pregnancy and the Risk of Selected Birth Defects: A Prospective Cohort Study

Contains fulltext : 97906.pdf (publisher's version ) (Open Access)BACKGROUND: Since use of non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy is common, small increases in the risk of birth defects may have significant implications for public health. Results of human studies on the teratogenic risks of NSAIDs are inconsistent. Therefore, we evaluated the risk of selected birth defects after prenatal exposure to prescribed and over-the-counter NSAIDs. METHODS AND FINDINGS: We used data on 69,929 women enrolled in the Norwegian Mother and Child Cohort Study between 1999 and 2006. Data on NSAID exposure were available from a self-administered questionnaire completed around gestational week 17. Information on pregnancy outcome was obtained from the Medical Birth Registry of Norway. Only birth defects suspected to be associated with NSAID exposure based upon proposed teratogenic mechanisms and previous studies were included in the multivariable logistic regression analyses. A total of 3,023 women used NSAIDs in gestational weeks 0-12 and 64,074 women did not report NSAID use in early pregnancy. No associations were observed between overall exposure to NSAIDs during pregnancy and the selected birth defects separately or as a group (adjusted odds ratio 0.7, 95% confidence interval 0.4-1.1). Associations between maternal use of specific types of NSAIDs and the selected birth defects were not found either, although an increased risk was seen for septal defects and exposure to multiple NSAIDs based on small numbers (2 exposed cases; crude odds ratio 3.9, 95% confidence interval 0.9-15.7). CONCLUSIONS: Exposure to NSAIDs during the first 12 weeks of gestation does not seem to be associated with an increased risk of the selected birth defects. However, due to the small numbers of NSAID-exposed infants for the individual birth defect categories, increases in the risks of specific birth defects could not be excluded

Симптомы сезонных аффективных расстройств (САД) и снижение качества жизни (КЖ) как предикторы снижения функциональных резервов организма к африканских студентов-медиков во время учёбы и жизни в Москве

We showed that African students during their studies and life in Moscow during the winter (December-January) in relation to the summer period (June) significantly reduced the functional reserves of the body. The total index of symptoms of seasonal affective disorders (SAD) in winter was 9 ± 0.4 units, and in the summer period the same indicator was 4±0.4 unit. (P≤0.05). Such integrative indicators of the Quality of Life (QoL) as Mental (MH) and Physical Health (PH) were also significantly lower among African medical students in the winter period.The total index of the Heart Rhythm Variability (HRV) for R.M. Bayevsky (1-4), correlated with the level of functional reserves of the body (IARS - Regulatory System Activity Index) was significantly higher in the surveyed African students in the winter period compared to the same indicator in the surveyed in the summer period - 6±0.4 and 2 ± 0.1 respectively (P≤ 0.05).The data obtained show that the received Quality of Life and the degree of expression of seasonal affective disorders can serve as predictive predictors in assessing the level of functional reserves of the body of African students in changed climatic and geographical conditions.Нами было показано, что у Африканских студентов во время учёбы и жизни в Москве в зимний период (декабрь-январь) по отношению к летнему периоду (июнь) существенно снизились функциональные резервы организма. Суммарный показатель выраженности симптомов сезонных аффективных расстройств (САР) в зимний период составил 9±0.4 ед., а в летний период аналогичный показатель был равен 4±0.4 ед. (Р≤0.05).Такие интегративные показатели Качества Жизни (КЖ) как Ментальное (МЗ) и Физическое Здоровье (ФЗ) были также существенно ниже у Африканских студентов- медиков в зимний период времени.Суммарный показатель Вариабельности Сердечного Ритма (ВСР) по Р.М. Баевскому, соотносящийся с уровнем функциональных резервов организма (ПАРС - Показатель Активности Регуляторных Систем) был существенно выше у обследуемых Африканских студентов в зимний период времени по отношению к аналогичному показателю у обследуемых в летний период времени - 6±0.4 и 2±0.1 соответственно (Р≤0.05).Полученные данные свидетельствуют о том, что полученные показатели Качества Жизни и степень выраженности Сезонных аффективных расстройств могут служить прогностическими предикторами при оценке уровня функциональных резервов организма Африканских студентов изменённых климато-географических условиях