Bahado-Singh Ray O, Schenone Mauro, Cordoba Marcos, Shieh Wen-Shi, Maulik Devika, Kruger Michael, Reece E Albert
Department of OB/GYN, Wayne State University School of Medicine, Detroit, Michigan, USA.
J Matern Fetal Neonatal Med. 2011 May;24(5):687-91. doi: 10.3109/14767058.2010.529970. Epub 2011 Mar 7.
Oxidative stress (OS) is an important mechanism of teratogenesis. Recent work suggests increased OS in males. We evaluated whether male gender increased the risk of cyanotic congenital heart defects (CCHD) whose development is linked to OS and other common congenital anomalies (CA) in non-diabetic pregnancies.
CDC-National Center for Health Statistics data for 19 states in 2006 were reviewed. CCHD, anencephaly, spina bifida, congenial diaphragmatic hernia (CDH), omphalocele, gastroschisis, limb defects, cleft lip with or without cleft palate (CL/P) and isolated cleft palate were evaluated. Adjusted odds ratio (OR) (95% CI) were calculated for CA in males with females as the reference group.
Of 1,194, 581, cases analyzed after exclusions, 3037 (0.25%) had major CA. Males had elevated adjusted OR (95% CI) for CCHD: 1.198 (1.027, 1.397), CDH: 1.487 (1.078, 2.051), and CL/P: 1.431 (1.24, 1.651). There was a significant interaction between cigarette use and (male) fetal gender and also with maternal age in the CL/P group.
In non-diabetic pregnancies, male gender appears to be an independent risk factor for some types of CA believed to be associated with OS. Cigarette smoking, a well recognized source of OS only increased the risk of CL/P in males.
氧化应激(OS)是致畸的重要机制。近期研究表明男性体内的氧化应激增加。我们评估了男性性别是否会增加非糖尿病妊娠中与OS及其他常见先天性异常(CA)相关的青紫型先天性心脏病(CCHD)的发病风险。
回顾了2006年19个州疾病预防控制中心 - 国家卫生统计中心的数据。对CCHD、无脑儿、脊柱裂、先天性膈疝(CDH)、脐膨出、腹裂、肢体缺陷、唇裂伴或不伴腭裂(CL/P)以及孤立性腭裂进行了评估。以女性为参照组,计算男性患先天性异常的校正比值比(OR)(95%置信区间)。
在排除后分析的1,194,581例病例中,3037例(0.25%)患有主要先天性异常。男性患CCHD的校正OR(95%置信区间)升高:1.198(1.027, 1.397),患CDH的校正OR为:1.487(1.078, 2.051),患CL/P的校正OR为:1.431(1.24, 1.651)。在CL/P组中,吸烟与(男性)胎儿性别以及母亲年龄之间存在显著交互作用。
在非糖尿病妊娠中,男性性别似乎是某些被认为与氧化应激相关的先天性异常类型的独立危险因素。吸烟是一种公认的氧化应激源,仅增加了男性患CL/P的风险。