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静脉血栓栓塞症与子痫前期/子痫无强烈家族易感性:瑞典全国范围内的家族研究。

Venous thromboembolism does not share strong familial susceptibility with pre-eclampsia/eclampsia: a nationwide family study in Sweden.

机构信息

Centre for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.

出版信息

BJOG. 2013 Sep;120(10):1200-6. doi: 10.1111/1471-0528.12216. Epub 2013 Mar 21.

Abstract

OBJECTIVE

Genetic variants associated with venous thromboembolism (VTE) have been suggested to be involved in the pathogenesis of pre-eclampsia/eclampsia (PEC/EC). This nationwide study aimed to determine whether VTE shares familial susceptibility with PEC/EC.

DESIGN

Population-based cohort study.

SETTING

Sweden.

SAMPLE

A total of 941 841 Swedish women delivering their first child between 1987 and 2008.

METHODS

Data from the Swedish Multigeneration Register were linked to the Swedish Hospital Discharge Register. The risk of PEC/EC was determined in primiparous women with a family history of VTE (in parents and/or siblings), compared with primiparous women without a family history of VTE. Odds ratios (ORs) were calculated by logistic regression.

MAIN OUTCOME MEASURE

PEC/EC in first pregnancy.

RESULTS

In total, 43 621 women had PEC/EC in association with their first pregnancy. The OR for PEC/EC in women with a family history of VTE was 1.06 (95% CI 1.01-1.11); however, a family history of VTE was associated with higher odds of PEC/EC among women with previous hypertension (OR 1.38, 95% CI 1.25-1.52).

CONCLUSION

A family history of VTE is weakly associated with PEC/EC risk, and is not clinically useful for the prediction of PEC/EC. The results of the present study suggest that it is unlikely that strong disease-causing mutations shared by VTE and PEC/EC are common in the Swedish population. The novel association between family history and PEC/EC among the subgroup with previous hypertension needs further confirmation in future studies.

摘要

目的

与静脉血栓栓塞症(VTE)相关的遗传变异被认为参与了子痫前期/子痫(PEC/EC)的发病机制。本全国性研究旨在确定 VTE 是否与 PEC/EC 具有家族易感性。

设计

基于人群的队列研究。

设置

瑞典。

样本

1987 年至 2008 年间分娩第一胎的 941841 名瑞典女性。

方法

从瑞典多代登记处获取数据,并与瑞典住院病人登记处进行关联。在有 VTE 家族史(父母和/或兄弟姐妹)的初产妇中,确定 PEC/EC 的风险,与没有 VTE 家族史的初产妇进行比较。通过逻辑回归计算比值比(OR)。

主要观察指标

首次妊娠的 PEC/EC。

结果

共有 43621 名妇女在首次妊娠时发生 PEC/EC。有 VTE 家族史的妇女发生 PEC/EC 的 OR 为 1.06(95%CI 1.01-1.11);然而,有 VTE 家族史的妇女既往有高血压史时,发生 PEC/EC 的可能性更高(OR 1.38,95%CI 1.25-1.52)。

结论

VTE 的家族史与 PEC/EC 的风险有微弱关联,对 PEC/EC 的预测无临床意义。本研究结果表明,在瑞典人群中,VTE 和 PEC/EC 之间共同存在的强致病突变不太可能很常见。在有既往高血压史的亚组中,家族史与 PEC/EC 之间的新关联需要在未来的研究中进一步证实。

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