- 期刊
放射線檢查與懷孕孕期之探討
Radiography during the Three Trimesters of Pregnancy
摘要
部分孕婦接受放射線檢查時，並不知道自己是懷孕初期，有些是因為重大原因或是車禍，到醫院必須要照X光而接受輻射。當她們知道懷孕接受放射線檢查可能會影響胎兒健康時，部分的人會因此一直煩惱著胎兒的風險，另一部分的人會過於擔心而終止懷孕，以上這問題是我們應該去面對的。這些接受X光照射的孕婦，如果可以評估接受到的劑量，可以在事前降低其放射線劑量並評估所造成的輻射風險。本研究利用2008-2010年健保資料庫百萬歸人檔，剔除多胞胎及沒有產檢紀錄等因素之產婦，取得總產婦共14,133人次，比較懷孕期間接受放射線檢查產婦（1,101人次）與懷孕期間沒有接受放射線檢查產婦（13,032人次）在不同懷孕孕期對於新生兒出生異常指標之影響。懷孕孕期分為三部份：第一孕期、第二孕期與第三孕期，再將懷孕婦女分為是否接受放射線檢查兩個族群，以早產（懷孕週數少於37週）及體重不足（出 生體重小於2,500g）為研究變項，使用卡方檢定與羅吉斯迴歸去分析關聯性與勝算比。本研究結果顯示，懷孕期間在任一孕期接受放射線檢查，對於新生兒出生異常指標之影響無顯著差異。懷孕期間接受放射線檢查還是需要經過臨床醫師的評估，對於女性檢查者，不確定是否懷孕前，應以超音波和磁振造影為主，將放射線檢查視為第三線工具。雖然放射診斷科的檢查，胎兒所遭受的輻射劑量皆低於50mGy，但要注意 的是懷孕期間接受放射線檢查的次數與累積的劑量。
並列摘要
Some pregnant women when receiving radiation examination do not know they are pregnant. Some others must be exposed to radiation to confirm the severity because of inevitable reasons like car accidents. When they know radiography during pregnancy might affect fetal health, some of them will therefore worry about the risk of the fetus, even parts of the people will be too worry and then decide to terminate the pregnancy. In fact, this is the problem that we should always face to. In this study, a total of 14,133 pregnant women were evaluated, excluding the women with multiple births or without examination records, from 2008-2010 National Health Insurance Research Database in Taiwan. Abnormal performance indicators in newborns were compared between pregnant women receiving (1,101 people) and not receiving (13,032 people) radiation examinations during pregnancy. The relevance and odds ratios during three trimesters were analyzed according to the outcomes of premature birth (less than 37 weeks gestational age) and low birth weight (less than 2,500g) by chi-square test and Logistic regression, respectively. This study inferred that receiving radiographs does not increase the risk of low birth weight during pregnancy, but it does not mean that one could accept unlimited radiographs. For female patients with uncertain of pregnancy, ultrasound and MRI should be treated prior to radiography in the clinic.