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孕妇先兆子痫或合并慢性高血压与后代先天畸形风险的相关性:基于人群的病例对照研究。

Association of pre-eclampsia with or without superimposed chronic hypertension in pregnant women with the risk of congenital abnormalities in their offspring: a population-based case-control study.

机构信息

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

出版信息

Eur J Obstet Gynecol Reprod Biol. 2012 Jul;163(1):17-21. doi: 10.1016/j.ejogrb.2012.03.015. Epub 2012 Apr 14.

Abstract

OBJECTIVE

To investigate the association of pre-eclampsia (PE) or PE with superimposed chronic hypertension (PE+SCH) in pregnant women with the risk of various structural birth defects (i.e. congenital abnormalities) in their offspring.

STUDY DESIGN

A population-based case-control study using the Hungarian Case-Control Surveillance of Congenital Abnormalities data set (1980-1996), including 22,843 cases with congenital abnormalities and 38,151 matched controls without any congenital abnormalities. The incidence of PE and PE+SCH was compared in women who had offspring with congenital abnormalities (cases) and women who had offspring without any congenital abnormalities (controls).

RESULTS

The incidence of PE was examined in 585 cases and 1017 controls, and the incidence of PE+SCH was examined in 154 cases and 269 controls. None of the 25 studied types of congenital abnormality was found to be more likely among the offspring of women with PE. However, the risks of renal dysgenesis [odds ratio (OR) 4.7, 95% confidence interval (CI) 1.7-12.8], esophageal atresia/stenosis (OR 4.6, 95% CI 1.8-12.2) and rectal/anal stenosis (OR 3.7, 95% CI 1.6-8.5) were higher in the offspring of pregnant women with PE+SCH.

CONCLUSIONS

PE in pregnant women was not associated with a higher risk of any congenital abnormalities in their offspring, but PE+SCH was associated with a higher risk of renal dysgenesis, esophageal atresia/stenosis and rectal/anal stenosis. These findings need confirmation in other studies.

摘要

目的

探讨孕妇先兆子痫(PE)或 PE 合并慢性高血压(PE+SCH)与后代发生各种结构出生缺陷(即先天性异常)的风险之间的关系。

研究设计

采用基于人群的病例对照研究方法,利用匈牙利先天性异常病例对照监测数据集(1980-1996 年),纳入 22843 例先天性异常患儿病例和 38151 例无任何先天性异常的匹配对照。比较有先天性异常后代的妇女(病例)和无先天性异常后代的妇女(对照)中 PE 和 PE+SCH 的发生率。

结果

检查了 585 例病例和 1017 例对照中的 PE 发生率,以及 154 例病例和 269 例对照中的 PE+SCH 发生率。在患有 PE 的女性的后代中,没有发现任何 25 种研究类型的先天性异常更有可能发生。然而,PE+SCH 孕妇的后代发生肾发育不良的风险较高[比值比(OR)4.7,95%置信区间(CI)1.7-12.8]、食管闭锁/狭窄(OR 4.6,95% CI 1.8-12.2)和直肠/肛门狭窄(OR 3.7,95% CI 1.6-8.5)的风险较高。

结论

孕妇 PE 与后代发生任何先天性异常的风险增加无关,但 PE+SCH 与肾发育不良、食管闭锁/狭窄和直肠/肛门狭窄的风险增加相关。这些发现需要在其他研究中进一步证实。

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