Department of Obstetrics and Gynecology and Children's Hospital, University Central Hospital, Helsinki, the THL National Institute for Health and Welfare, Helsinki, and the Science Center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere, Finland; and the Nordic School of Public Health, Gothenburg, Sweden.
Obstet Gynecol. 2013 Aug;122(2 Pt 1):268-274. doi: 10.1097/AOG.0b013e31829a6f91.
To examine the association between major congenital anomalies and placental abruption.
A register-based retrospective case-control study was carried out from 1987 to 2005. Data on baseline characteristics and birth outcomes were collected from three Finnish national health registers: the Medical Birth Register, National Hospital Discharge Register, and Register of Congenital Malformations. The study population consisted of 4,190 women with singleton birth and placental abruption. Three control women without placental abruption were selected for each case, matched by maternal age, parity, year of birth, and hospital district. The main outcome measure of the study was a major congenital anomaly associated with placental abruption.
In total, 261 (prevalence 623/10,000) births with placental abruption and 415 (prevalence 330/10,000) control births had major congenital anomalies (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.6-2.52). The association was strongest among births with growth restriction and prematurity. Adjusted analysis revealed a significant association with central nervous system anomalies (OR 2.33, 95% CI 1.29-4.23), anomalies of the eyes and ears (OR 1.82, 95% CI 1.08-3.09), cardiovascular anomalies (OR 1.78, 95% CI 1.34-2.37), respiratory anomalies (OR 3.51, 95% CI 1.56-7.90), gastrointestinal anomalies (OR 3.81, 95% CI 2.27-6.41), genitourinary anomalies (OR 2.55, 95% CI 1.73- 3.74), musculoskeletal anomalies (OR 1.67, 95% CI 1.24-2.24), and anomalies of integument (OR 3.29, 95% CI 1.20-8.98) in births complicated by placental abruption.
Major congenital anomalies are twice as common among neonates born from pregnancies complicated by placental abruption compared with control pregnancies without abruption. This observation applies to several organ systems.
II.
探讨主要先天畸形与胎盘早剥的关系。
这是一项基于注册的回顾性病例对照研究，于 1987 年至 2005 年进行。数据来自三个芬兰国家健康登记处：医疗出生登记处、国家住院病人出院登记处和先天性畸形登记处，收集了基本特征和出生结局的数据。研究人群由 4190 名患有单胎胎盘早剥的妇女组成。每例胎盘早剥的妇女匹配 3 名未发生胎盘早剥的对照妇女，匹配因素包括母亲年龄、产次、出生年份和医院区。本研究的主要结局指标是与胎盘早剥相关的主要先天畸形。
共有 261 例（发生率为 623/10000）胎盘早剥分娩和 415 例（发生率为 330/10000）对照组分娩发生主要先天畸形（比值比[OR]为 1.92，95%置信区间[CI]为 1.6-2.52）。这种关联在存在生长受限和早产的分娩中最强。调整分析显示，与中枢神经系统异常（OR 2.33，95%CI 1.29-4.23）、眼耳异常（OR 1.82，95%CI 1.08-3.09）、心血管异常（OR 1.78，95%CI 1.34-2.37）、呼吸异常（OR 3.51，95%CI 1.56-7.90）、胃肠道异常（OR 3.81，95%CI 2.27-6.41）、泌尿生殖系统异常（OR 2.55，95%CI 1.73-3.74）、肌肉骨骼异常（OR 1.67，95%CI 1.24-2.24）和皮肤异常（OR 3.29，95%CI 1.20-8.98）均有显著相关性。
与无胎盘早剥的对照组妊娠相比，胎盘早剥孕妇所分娩的新生儿先天畸形的发生率增加了 1 倍。这一观察结果适用于多个器官系统。
II 级。
