母亲糖尿病与食管闭锁风险。

Maternal diabetes and risk of esophageal atresia.

机构信息

Department of Molecular Medicine and Surgery, Upper Gastrointestinal Research, Karolinska Institutet, SE-171 76 Stockholm, Sweden.

出版信息

J Pediatr Surg. 2010 Oct;45(10):2004-8. doi: 10.1016/j.jpedsurg.2010.06.008.

DOI:10.1016/j.jpedsurg.2010.06.008

PMID:20920719

Abstract

BACKGROUND

The etiology of esophageal atresia is poorly understood. The incidence of some congenital malformations is increased in children of mothers with diabetes, but the role of maternal diabetes in esophageal atresia development in the infant is unknown. We hypothesized that maternal diabetes increases the risk of esophageal atresia in the infant.

METHODS

A population-based, matched case-control study, nested within a cohort of neonates born in Sweden in January 1, 1982 through December 31, 2007, was undertaken. Conditional logistic regression was used to calculate relative risks, expressed as odds ratios with 95% confidence intervals. Adjustment for confounding was made through matching and by multivariable regression.

RESULTS

Among 2,625,436 newborn infants in the study cohort, there were 780 cases of esophageal atresia, and 7,800 infants were matched and randomly selected as controls. Exposure to preexisting or gestational diabetes was more frequent in the mothers of the case group (n = 18; 2.3%) than in those of the control group (n = 103; 1.3%). The adjusted risk of esophageal atresia was 70 % higher among infants of women with diabetes than among women without diabetes (odds ratio, 1.7; 95% confidence interval, 1.0-2.9).

CONCLUSIONS

Maternal diabetes might increase the risk of esophageal atresia in the child.

摘要

背景

食管闭锁的病因尚未完全阐明。一些先天性畸形在患有糖尿病的母亲的孩子中发病率增加，但母亲糖尿病在婴儿食管闭锁发展中的作用尚不清楚。我们假设母亲糖尿病会增加婴儿患食管闭锁的风险。

方法

这是一项基于人群的病例对照研究，嵌套在 1982 年 1 月 1 日至 2007 年 12 月 31 日期间在瑞典出生的新生儿队列中进行。使用条件逻辑回归计算相对风险，以优势比（95%置信区间）表示。通过匹配和多变量回归进行混杂因素调整。

结果

在研究队列的 2625436 名新生儿中，有 780 例食管闭锁，7800 名婴儿被匹配并随机选择为对照组。与对照组（n=103，1.3%）相比，病例组（n=18，2.3%）的母亲更常患有既往或妊娠期糖尿病。与没有糖尿病的母亲相比，患有糖尿病的母亲的婴儿患食管闭锁的风险增加了 70%（比值比，1.7；95%置信区间，1.0-2.9）。