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孕妇有症状性胆石症-合并胆囊炎与子代先天异常的可能相关性:一项基于人群的病例对照研究。

Possible association between symptomatic cholelithiasis-complicated cholecystitis in pregnant women and congenital abnormalities in their offspring--a population-based case-control study.

机构信息

Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2009 Oct;146(2):152-5. doi: 10.1016/j.ejogrb.2009.04.008. Epub 2009 May 7.

Abstract

OBJECTIVE

To estimate the risk of congenital abnormalities in the offspring of pregnant women with symptomatic cholelithiasis and complicated cholecystitis.

STUDY DESIGN

Comparison of the occurrence of medically recorded symptomatic cholelithiasis and complicated cholecystitis occurred any time of pregnancy (particularly in the second and/or third gestational month) of pregnant women who had malformed foetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities.

RESULTS

Of 22,843 cases with CA, 62 (0.27%) had mothers with symptomatic cholelithiasis, while 119 (0.31%) mothers of 38,151 controls were recorded with symptomatic cholelithiasis. In addition, the mothers of 109 cases (0.48%) were affected by complicated cholecystitis during pregnancy compared with 145 controls (0.38%). Regarding the frequency, these two biliary diseases did not show any significant differences in the maternal variables, therefore case mothers were combined. The analysis of specific groups of congenital abnormalities showed an association between symptomatic cholelithiasis-complicated cholecystitis in the second and/or third gestation months, and neural tube defects (adjusted OR with 95% CI: 4.1, 1.3-13.4).

CONCLUSION

A higher rate of neural tube defects was found in the offspring of mothers with severe diseases of the biliary system during pregnancy. This finding needs to be confirmed by further studies and/or explanations to determine whether it is causal or a chance event.

摘要

目的

评估有症状性胆石症和合并胆囊炎的孕妇所生子女先天畸形的风险。

研究设计

比较在基于人群的匈牙利先天畸形病例对照监测系统中,患有畸形胎儿/新生儿的孕妇(病例)和分娩健康婴儿的孕妇(对照)所记录的有症状性胆石症和合并胆囊炎的发生情况,这些孕妇的胆石症和胆囊炎发生在妊娠期间(尤其是妊娠第 2 和/或第 3 个月)。

结果

在 22843 例 CA 中,有 62 例(0.27%)母亲患有症状性胆石症,而 38151 例对照中 119 例(0.31%)母亲患有症状性胆石症。此外,109 例(0.48%)病例的母亲在妊娠期间患有合并胆囊炎,而 145 例(0.38%)对照中患有该疾病。就频率而言,这两种胆道疾病在母亲变量中没有显示出任何显著差异,因此将病例母亲合并在一起。对特定先天畸形组的分析表明,妊娠第 2 和/或第 3 个月的症状性胆石症-合并胆囊炎与神经管缺陷之间存在关联(调整后的 OR 及其 95%CI:4.1,1.3-13.4)。

结论

在患有严重妊娠期间胆道系统疾病的母亲的子女中,神经管缺陷的发生率更高。这一发现需要通过进一步的研究和/或解释来证实,以确定其是否是因果关系还是偶然事件。

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