The Natalie S, Honein Margaret A, Caton Alissa R, Moore Cynthia A, Siega-Riz Anna Maria, Druschel Charlotte M
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Am J Med Genet A. 2007 Oct 1;143A(19):2274-84. doi: 10.1002/ajmg.a.31926.
Biliary atresia is a rare birth defect that affects 1 in 12,000 to 1 in 19,500 live births. We used data from the National Birth Defects Prevention Study, a multistate case-control study, to identify potential risk factors for isolated biliary atresia (no additional unrelated major birth defects diagnosed). Infants were identified from eight states from 1997 to 2002, with clinical information abstracted from medical records. Potential risk factors assessed include: demographic factors, seasonality, preterm birth, maternal smoking, maternal alcohol use, maternal illicit drug use, maternal health, maternal medication use, maternal vitamin use, and maternal nutrition. Infants of non-Hispanic black mothers were more likely to have biliary atresia than infants of non-Hispanic white mothers (adjusted odds ratio (aOR) = 2.29, 95% confidence interval (CI) 1.07-4.93) and infants conceived during the spring season were more likely to have biliary atresia than infants conceived in winter (aOR = 2.33, 95%CI 1.05-5.16). Low intakes of vitamin E, copper, phosphorus, and beta tocopherol were associated with the occurrence of isolated biliary atresia (borderline significance). Low iron intake had a borderline inverse association with biliary atresia. While this analysis provides support for previous reports of a possible association between seasonal variation and the occurrence of biliary atresia, more data are needed to evaluate whether the seasonal variation is related to infectious agents. The role of nutrients in the development of biliary atresia remains unclear. Further studies of genetic, infectious, and nutrient exposures and the association of biliary atresia are warranted.
胆道闭锁是一种罕见的出生缺陷,在每12000至19500例活产中出现1例。我们使用了来自全国出生缺陷预防研究的数据,这是一项多州病例对照研究,以确定孤立性胆道闭锁(未诊断出其他无关的主要出生缺陷)的潜在风险因素。从1997年至2002年在八个州识别出婴儿,并从医疗记录中提取临床信息。评估的潜在风险因素包括:人口统计学因素、季节性、早产、母亲吸烟、母亲饮酒、母亲使用非法药物、母亲健康状况、母亲用药、母亲维生素使用情况以及母亲营养状况。非西班牙裔黑人母亲的婴儿比非西班牙裔白人母亲的婴儿更易患胆道闭锁(校正比值比(aOR)=2.29,95%置信区间(CI)1.07 - 4.93),春季受孕的婴儿比冬季受孕的婴儿更易患胆道闭锁(aOR = 2.33,95%CI 1.05 - 5.16)。维生素E、铜、磷和β生育酚的低摄入量与孤立性胆道闭锁的发生相关(具有临界显著性)。铁摄入量低与胆道闭锁存在临界负相关。虽然该分析为先前关于季节性变化与胆道闭锁发生之间可能存在关联的报告提供了支持,但需要更多数据来评估季节性变化是否与感染因子有关。营养素在胆道闭锁发展中的作用仍不清楚。有必要进一步研究基因、感染和营养素暴露以及与胆道闭锁的关联。
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