Meberg Alf, Hals Jardar, Thaulow Erik
Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway.
Acta Paediatr. 2007 Aug;96(8):1142-5. doi: 10.1111/j.1651-2227.2007.00381.x. Epub 2007 Jun 21.
To register chromosomal anomalies, syndromes and extracardiac malformations in patients with Congenital heart defects (CHDs).
Population-based prospective observational study.
Of 57 027 live births during 1982-2005, CHDs were detected in 662 (11.6 per 1000), of whom 146 (22%) had associated anomalies. Of these 52 (36%) had chromosomal anomalies (exclusive microdeletions), 26 (18%) genetic syndromes/microdeletions, 1 (0.7%) a teratogenous syndrome and 67 (46%) extracardiac malformations. In perimembraneous ventricular septal defects (VSDs), associated anomalies occurred in 22 of 70 (31%) compared to 27 of 298 (9%) in VSDs located in the muscular part of the septum (p < 0.0001). The prevalence of CHDs with associated disorders increased significantly from the cohort born during 1982-1993 to those born during 1994-2005 (2.0 vs. 3.1 per 1000, respectively; p < 0.0001), mainly caused by an increase of chromosomal trisomies (0.5 vs. 1.1 per 1000; p = 0.026). The percentage of women giving live birth at 35 years of age or more was 7.6% for the period 1982-1993 compared to 13.4% for 1994-2005 (p = 0.001).
Chromosomal anomalies, syndromes and extracardiac malformations occurred in nearly one-fourth of CHD cases. Muscular VSDs had a low prevalence of such conditions. The prevalence of CHDs with chromosomal trisomies increased, and was probably related to an increasing age of women giving birth.
登记先天性心脏病(CHD)患者的染色体异常、综合征及心外畸形。
基于人群的前瞻性观察研究。
在1982年至2005年期间的57027例活产儿中,检测出662例CHD(每1000例中有11.6例),其中146例(22%)伴有相关异常。在这些患者中,52例(36%)有染色体异常(不包括微缺失),26例(18%)有遗传综合征/微缺失,1例(0.7%)有致畸综合征,67例(46%)有心外畸形。在膜周部室间隔缺损(VSD)中,70例中有22例(31%)伴有相关异常,而位于室间隔肌部的VSD中,298例中有27例(9%)伴有相关异常(p<0.0001)。伴有相关疾病的CHD患病率从1982年至1993年出生的队列显著增加至1994年至2005年出生的队列(分别为每1000例中有2.0例和3.1例;p<0.0001),主要是由于染色体三体增加(每1000例中有0.5例和1.1例;p=0.026)。1982年至1993年期间,35岁及以上活产的女性比例为7.6%,而1994年至2005年为13.4%(p=0.001)。
近四分之一的CHD病例存在染色体异常、综合征及心外畸形。肌部VSD此类情况的患病率较低。染色体三体CHD的患病率增加,可能与生育女性年龄增加有关。