Varela María M Morales-Suárez, Nohr Ellen Aagaard, Llopis-González Agustin, Andersen Ann-Marie Nybo, Olsen Jorn
Department of Preventive Medicine, University of Valencia, Valencia, Spain.
Eur J Public Health. 2009 Apr;19(2):161-7. doi: 10.1093/eurpub/ckp003. Epub 2009 Feb 12.
The aim of this study is to investigate the association between socio-occupational status and the frequency of major congenital anomalies in offspring.
The study population comprised 81,435 live singletons born to mothers enrolled in the Danish National Birth Cohort between 1996 and 2002. A total of 3352 cases of major congenital anomalies (EUROCAT criteria) were identified by linkage to the National Hospital Discharge Register. Malformations were recorded at birth or in the first year of life. Information about maternal and paternal socio-occupational status was collected prospectively using telephone interviews in the second trimester of pregnancy and was categorized as high, middle or low. Associations were measured as relative prevalence ratios using the highest socio-occupational status within the couple as the reference group.
The prevalence of all recorded major congenital anomalies was similar, about 4%, in all the socio-occupational categories. Low social status of the couple did, however, correlate with a higher prevalence of congenital anomalies of the 'respiratory system'. No association was substantially attenuated when we adjusted for maternal and paternal age, smoking status, maternal alcohol habits, folic acid intake and body mass index. When malformations of the heart and the cardiovascular system were grouped together, they were more frequent in families where both parents presented a low socio-occupational status.
We detected an association between low socio-occupational status and congenital anomalies of the respiratory system, the heart and the circulatory system. These malformations are good candidates for a large study on occupational, environmental and social determinants.
本研究旨在调查社会职业地位与后代主要先天性异常发生频率之间的关联。
研究人群包括1996年至2002年间在丹麦国家出生队列登记的母亲所生的81435名单胎活产儿。通过与国家医院出院登记处的数据链接,共识别出3352例符合欧洲先天性异常监测系统(EUROCAT)标准的主要先天性异常病例。畸形情况在出生时或出生后第一年进行记录。通过孕期中期的电话访谈前瞻性收集有关母亲和父亲社会职业地位的信息,并将其分为高、中、低三类。以夫妻双方中最高的社会职业地位作为参照组,采用相对患病率比来衡量两者之间的关联。
在所有社会职业类别中,所有记录的主要先天性异常的患病率相似,约为4%。然而,夫妻社会地位较低与“呼吸系统”先天性异常的较高患病率相关。在对母亲和父亲的年龄、吸烟状况、母亲饮酒习惯、叶酸摄入量和体重指数进行调整后,这种关联并未明显减弱。当将心脏和心血管系统的畸形合并在一起时,父母双方社会职业地位均较低的家庭中此类畸形更为常见。
我们发现社会职业地位较低与呼吸系统、心脏和循环系统的先天性异常之间存在关联。这些畸形是职业、环境和社会决定因素大型研究的理想对象。