Acs Nándor, Bánhidy Ferenc, Puhó Erzsébet H, Czeizel Andrew E
Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary.
Congenit Anom (Kyoto). 2006 Jun;46(2):86-96. doi: 10.1111/j.1741-4520.2006.00108.x.
Diseases of respiratory system caused by acute infections are among the most common maternal diseases during pregnancy. The objective of the study was to estimate the association between congenital abnormalities and acute respiratory infections during the first trimester of pregnancy. The data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities including 22 843 cases with congenital abnormalities, 38 151 population controls without congenital abnormalities and 834 malformed controls with Down syndrome between 1980 and 1996 was evaluated. 2118 cases with congenital abnormalities (9.3%), 3455 population controls (9.1%) and 92 malformed controls with Down syndrome (11.0%) had mothers with acute respiratory infections. Of 25 different congenital abnormality groups, esophageal atresia/stenosis showed a high adjusted prevalence odds ratios (POR) with 95% confidence interval (CI) for acute respiratory infections during the first trimester of pregnancy in case mothers compared with population controls (3.6, 1.4-9.1) and malformed controls (1.9, 1.0-3.5), respectively. In addition there was an association between medically recorded acute respiratory infections during the first trimester of pregnancy and a higher risk for some other congenital abnormalities, such as posterior cleft palate and multiple congenital abnormalities. In conclusion a possible association between some congenital abnormalities, particularly esophageal atresia/stenosis and maternal acute respiratory infections cannot be excluded due to the interactions of the microbial agents, related drug treatments and last but not least the indirect effect of maternal diseases, such as fever-hyperthermia, hypoxia and dietary deficiency. However, periconceptional multivitamin/folic acid supplementation during the early pregnancy was able to reduce the acute respiratory infection related risk for congenital abnormalities.
急性感染引起的呼吸系统疾病是孕期最常见的孕产妇疾病之一。本研究的目的是评估妊娠早期先天性异常与急性呼吸道感染之间的关联。对匈牙利先天性异常病例对照监测数据集进行了评估，该数据集包括1980年至1996年间的22843例先天性异常病例、38151例无先天性异常的人群对照以及834例唐氏综合征畸形对照。2118例先天性异常病例（9.3%）、3455例人群对照（9.1%）和92例唐氏综合征畸形对照（11.0%）的母亲患有急性呼吸道感染。在25个不同的先天性异常组中，与人群对照（3.6，1.4 - 9.1）和畸形对照（1.9，1.0 - 3.5）相比，食管闭锁/狭窄在病例母亲妊娠早期急性呼吸道感染方面显示出较高的调整患病率比值比（POR）及95%置信区间（CI）。此外，妊娠早期医学记录的急性呼吸道感染与其他一些先天性异常风险较高之间存在关联，如腭裂和多发先天性异常。总之，由于微生物制剂、相关药物治疗的相互作用，以及孕产妇疾病的间接影响，如发热 - 高热、缺氧和饮食缺乏等，不能排除某些先天性异常，特别是食管闭锁/狭窄与孕产妇急性呼吸道感染之间可能存在的关联。然而，孕早期补充围孕期多种维生素/叶酸能够降低与急性呼吸道感染相关的先天性异常风险。
