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1986 - 1999年夏威夷特定先天性心脏缺陷的描述性流行病学

Descriptive epidemiology of selected congenital heart defects, Hawaii, 1986-1999.

作者信息

Forrester Mathias B, Merz Ruth D

机构信息

Hawaii Birth Defects Program, Honolulu, HI 96817-5157, USA.

出版信息

Paediatr Perinat Epidemiol. 2004 Nov;18(6):415-24. doi: 10.1111/j.1365-3016.2004.00594.x.

DOI:10.1111/j.1365-3016.2004.00594.x
PMID:15535817
Abstract

Congenital heart defects are the most common type of birth defect and contribute the most to infant mortality due to birth defects. This study examined the relationship between several demographic factors and selected congenital heart defects among the unique multiethnic population in Hawaii during 1986-99, using data from a population-based birth defects registry. Rates were significantly higher in 1993-99 than in 1986-92 for transposition of the great arteries and Ebstein's anomaly, and significantly lower for tetralogy of Fallot. Significantly elevated rates were found with maternal age of > or =35 years for ventricular septal defect, atrial septal defect, endocardial cushion defect, and hypoplastic left heart syndrome. When cases with a known chromosomal abnormality were excluded, elevated rates among the older maternal age group remained for ventricular septal defect, atrial septal defect, and hypoplastic left heart syndrome. Whites had significantly higher rates than one or more of the other racial/ethnic groups for Ebstein's anomaly and coarctation of aorta, and significantly lower rates for tetralogy of Fallot, atrial septal defect, pulmonary valve atresia/stenosis, tricuspid valve atresia/stenosis, and anomalous pulmonary venous return. Significantly higher rates were found among males for transposition of great arteries, aortic valve stenosis, and interrupted aortic arch and, among females, for ventricular septal defect, endocardial cushion defect, and anomalous pulmonary venous return. Some of these differences were consistent with the literature while others were not.

摘要

先天性心脏缺陷是最常见的出生缺陷类型,也是因出生缺陷导致婴儿死亡的主要原因。本研究利用基于人群的出生缺陷登记数据,调查了1986 - 1999年间夏威夷独特的多民族人群中若干人口统计学因素与特定先天性心脏缺陷之间的关系。1993 - 1999年,大动脉转位和埃布斯坦畸形的发病率显著高于1986 - 1992年,法洛四联症的发病率则显著降低。对于室间隔缺损、房间隔缺损、心内膜垫缺损和左心发育不全综合征,母亲年龄≥35岁时发病率显著升高。排除已知染色体异常的病例后,老年母亲年龄组中室间隔缺损、房间隔缺损和左心发育不全综合征的发病率仍然较高。在埃布斯坦畸形和主动脉缩窄方面,白人的发病率显著高于一个或多个其他种族/族裔群体;在法洛四联症、房间隔缺损、肺动脉瓣闭锁/狭窄、三尖瓣闭锁/狭窄和肺静脉异位引流方面,白人的发病率则显著较低。在大动脉转位、主动脉瓣狭窄和主动脉弓中断方面,男性的发病率显著较高;在室间隔缺损、心内膜垫缺损和肺静脉异位引流方面,女性的发病率显著较高。其中一些差异与文献报道一致,而另一些则不然。

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