Honein Margaret A, Kirby Russell S, Meyer Robert E, Xing Jian, Skerrette Nyasha I, Yuskiv Nataliya, Marengo Lisa, Petrini Joann R, Davidoff Michael J, Mai Cara T, Druschel Charlotte M, Viner-Brown Samara, Sever Lowell E
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Matern Child Health J. 2009 Mar;13(2):164-75. doi: 10.1007/s10995-008-0348-y. Epub 2008 May 17.
To evaluate the association between preterm birth and major birth defects by maternal and infant characteristics and specific types of birth defects.
We pooled data for 1995-2000 from 13 states with population-based birth defects surveillance systems, representing about 30% of all U.S. births. Analyses were limited to singleton, live births from 24-44 weeks gestational age.
Overall, birth defects were more than twice as common among preterm births (24-36 weeks) compared with term births (37-41 weeks gestation) (prevalence ratio [PR] = 2.65, 95% confidence interval [CI] 2.62-2.68), and approximately 8% of preterm births had a birth defect. Birth defects were over five times more likely among very preterm births (24-31 weeks gestation) compared with term births (PR = 5.25, 95% CI 5.15-5.35), with about 16% of very preterm births having a birth defect. Defects most strongly associated with very preterm birth included central nervous system defects (PR = 16.23, 95% CI 15.49-17.00) and cardiovascular defects (PR = 9.29, 95% CI 9.03-9.56).
Birth defects contribute to the occurrence of preterm birth. Research to identify shared causal pathways and risk factors could suggest appropriate interventions to reduce both preterm birth and birth defects.
根据母婴特征及特定类型的出生缺陷评估早产与主要出生缺陷之间的关联。
我们汇总了1995 - 2000年来自13个州基于人群的出生缺陷监测系统的数据，这些数据约占美国所有出生人数的30%。分析仅限于孕龄24 - 44周的单胎活产。
总体而言，与足月产（孕37 - 41周）相比，早产（24 - 36周）中出生缺陷的发生率高出两倍多（患病率比[PR]=2.65，95%置信区间[CI]2.62 - 2.68），约8%的早产存在出生缺陷。与足月产相比，极早产（孕24 - 31周）中出生缺陷的发生可能性高出五倍多（PR = 5.25，95% CI 5.15 - 5.35），约16%的极早产存在出生缺陷。与极早产关联最密切的缺陷包括中枢神经系统缺陷（PR = 16.23，95% CI 15.49 - 17.00）和心血管缺陷（PR = 9.29，95% CI 9.03 - 9.56）。
出生缺陷会导致早产的发生。识别共同因果途径和风险因素的研究可能会提出适当的干预措施，以减少早产和出生缺陷。
