Métneki Júlia, Puhó Erzsébet, Czeizel Andrew E
National Center for Epidemiology, Department of Human Genetics and Teratology, Budapest, Hungary.
Birth Defects Res A Clin Mol Teratol. 2005 Sep;73(9):617-23. doi: 10.1002/bdra.20177.
Isolated orofacial clefts (OFCs) are likely to be caused by gene-environment interaction; therefore, the objective of the current study was to evaluate the possible association between all maternal diseases during pregnancy and isolated cleft lip with or without cleft palate (CL+/-CP) and posterior cleft palate (PCP) in the offspring.
The database of the large population-based Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996, was evaluated. The database includes 1374 cases with isolated CL+/- CP and 601 with PCP, plus 38,151 matched population controls (without defects) and 20,868 patient controls with other defects. Data collection was based on prospective medical records, retrospective maternal data via a self-reported questionnaire, and home visits of nonresponding families.
An increased risk for isolated CL+/- CP was found for children born to mothers with influenza, common cold, orofacial herpes, and gastroenteritis during pregnancy. Risk for isolated PCP was increased in children of mothers with influenza, sinusitis, and bronchitis. Among chronic maternal diseases, epilepsy and angina pectoris showed a higher prevalence in the mothers of children born with isolated OFCs (cases).
Some maternal diseases are risk factors for the pathogenesis of isolated OFCs. It is worth considering the prevention of possible harmful effects of influenza by vaccination during the expected epidemic period.
孤立性口面部裂隙(OFCs)可能由基因 - 环境相互作用引起;因此,本研究的目的是评估孕期所有母体疾病与后代孤立性唇裂伴或不伴腭裂(CL+/-CP)及腭裂(PCP)之间的可能关联。
对基于人群的大型匈牙利先天性异常病例对照监测数据库(1980 - 1996年)进行评估。该数据库包括1374例孤立性CL+/-CP病例和601例PCP病例,以及38151名匹配的无缺陷人群对照和20868名患有其他缺陷的患者对照。数据收集基于前瞻性医疗记录、通过自我报告问卷收集的回顾性母体数据以及对无回应家庭的家访。
发现孕期患流感、普通感冒、口面部疱疹和肠胃炎的母亲所生子女患孤立性CL+/-CP的风险增加。患流感、鼻窦炎和支气管炎的母亲所生子女患孤立性PCP的风险增加。在慢性母体疾病中,癫痫和心绞痛在患有孤立性OFCs(病例)的儿童母亲中患病率较高。
一些母体疾病是孤立性OFCs发病机制的危险因素。在预期流行期间通过接种疫苗预防流感的可能有害影响是值得考虑的。