Abe Karon, Honein Margaret A, Moore Cynthia A
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Birth Defects Res A Clin Mol Teratol. 2003 Nov;67(11):911-8. doi: 10.1002/bdra.10130.
Renal anomalies occur in about three infants per 1000 live births and have been associated with several environmental risk factors. Researchers have yet to assess the effect of maternal febrile illnesses on renal anomalies, even though febrile illnesses have been associated with other birth defects. Our objective was to determine whether maternal illness, fever, or medication use during the first trimester of pregnancy is associated with the occurrence of renal anomalies.
In this population-based case-control study, we evaluated 192 infants with renal anomalies (renal agenesis [n = 44], obstructive defects [n = 134], and renal duplication defects [n = 14]) and 3029 infant without birth defects, all of whom were born in metropolitan Atlanta, Georgia, from 1968 through 1980. Maternal illness was defined as reported flu-like illness and/or episodic illness during the first trimester.
Our adjusted multivariate analyses showed that among the 192 case-infants, 38 had mothers with an illness (adjusted odds ratio [AOR], 1.71; 95% confidence interval [CI], 1.15-2.52), 20 had mothers who reported a fever (AOR, 1.80; 95% CI, 1.07-3.02) and 26 had mothers who reported taking medication (AOR, 1.69; 95% CI, 1.07-2.68). Fifteen mothers reported a fever and medication use (AOR, 1.90; 95% CI, 1.05-3.45). Nonprescription aspirin-containing medication use showed the strongest association (AOR, 3.45; 95% CI, 1.36-8.75) with renal anomalies.
Our data suggest that maternal exposure to illness, fever, and medication (particularly aspirin) may increase the risk of congenital renal anomalies.
每1000例活产婴儿中约有3例出现肾脏异常，且肾脏异常与多种环境危险因素相关。尽管发热性疾病与其他出生缺陷有关，但研究人员尚未评估母亲发热性疾病对肾脏异常的影响。我们的目的是确定孕期头三个月母亲患病、发热或用药是否与肾脏异常的发生有关。
在这项基于人群的病例对照研究中，我们评估了192例患有肾脏异常的婴儿（肾缺如[n = 44]、梗阻性缺陷[n = 134]和重复肾畸形[n = 14]）以及3029例无出生缺陷的婴儿，所有这些婴儿均于1968年至1980年在佐治亚州亚特兰大大都市地区出生。母亲患病定义为孕期头三个月报告有类似流感的疾病和/或偶发性疾病。
我们的校正多变量分析显示，在192例病例婴儿中，38例母亲患病（校正优势比[AOR]，1.71；95%置信区间[CI]，1.15 - 2.52），20例母亲报告发热（AOR，1.80；95% CI，1.07 - 3.02），26例母亲报告用药（AOR，1.69；95% CI: 1.07 - 2.68）。15例母亲报告发热且用药（AOR，1.90；95% CI，1.05 - 3.45）。使用含非处方阿司匹林的药物与肾脏异常的关联最强（AOR，3.45；95% CI，1.36 - 8.75）。
我们的数据表明，母亲患病、发热和用药（尤其是阿司匹林）可能会增加先天性肾脏异常的风险。
