Department of Epidemiology, The University of Iowa, Iowa City, IA, USA.
Am J Med Genet A. 2013 Jan;161A(1):70-5. doi: 10.1002/ajmg.a.35682. Epub 2012 Dec 13.
Diagnosis of a child with Duchenne or Becker muscular dystrophy (DBMD) may impact future maternal reproductive choice; however, little is known about the reproductive patterns of mothers with a male child diagnosed with DBMD. Using population-based surveillance data collected by the muscular dystrophy surveillance, tracking, and research network, the proportion of mothers who conceived and delivered a live birth following the diagnosis of DBMD in an affected male child and factors associated with such reproductive choice were identified. To accomplish this, maternal demographic data were linked to birth certificate data to construct the reproductive history for 239 mothers. Univariable and bivariable analyses were conducted to determine the proportion of mothers delivering a live birth and associated factors. By the time of the current study, 96 (40.2%) of the 239 mothers had at least one live birth following delivery of their oldest affected male child; 53 (22.2%) of these mothers had a live birth before and 43 (18.0%) had a live birth after DBMD diagnosis of a male child. Mothers with a live birth after diagnosis were significantly younger at diagnosis of the oldest affected male child (26.2 ± 4.2 years vs. 31.5 ± 5.5 years), and were less likely to be white non-Hispanic compared to those with no live birth after diagnosis. These results suggest that about one in five mothers deliver a live birth subsequent to DBMD diagnosis in a male child. Maternal age and race/ethnicity were associated with this reproductive choice.
对患有杜氏或贝克型肌营养不良症(DBMD)的儿童进行诊断可能会影响未来母亲的生育选择;然而,对于被诊断为 DBMD 的男性儿童的母亲的生育模式,我们知之甚少。利用肌肉营养不良症监测、跟踪和研究网络收集的基于人群的监测数据,确定了在患有 DBMD 的男性儿童被诊断后,母亲受孕并分娩活产的比例,以及与这种生育选择相关的因素。为了实现这一目标,将母亲的人口统计学数据与出生证明数据相关联,为 239 位母亲构建了生育史。进行单变量和双变量分析以确定分娩活产的母亲比例和相关因素。在本研究进行时,239 位母亲中有 96 位(40.2%)在其最年长的患病男性孩子分娩后至少有一次活产;其中 53 位(22.2%)在 DBMD 诊断之前有活产,43 位(18.0%)在 DBMD 诊断后有活产。在诊断出最年长的患病男性孩子后有活产的母亲的诊断年龄明显较小(26.2 ± 4.2 岁 vs. 31.5 ± 5.5 岁),与未在诊断后有活产的母亲相比,她们更不可能是非西班牙裔白人。这些结果表明,大约五分之一的母亲在男性儿童被诊断出 DBMD 后会分娩活产。母亲的年龄和种族/民族与这种生育选择有关。