Petrossian Robert A, Kuehl Karen S, Loffredo Christopher A
1Lombardi Comprehensive Cancer Center,Georgetown University,Washington,District of Columbia,United States of America.
2Children's National Medical Center,Sheikh Zayed Campus for Advanced Children's Medicine,Washington,District of Columbia,United States of America.
Cardiol Young. 2015 Aug;25(6):1086-92. doi: 10.1017/S1047951114001644. Epub 2014 Aug 28.
A known comorbidity of congenital cardiovascular malformations is low birth weight, but the reasons for this association remain obscure. This retrospective study examines the relationship between congenital cardiovascular malformations and the birth weight of singletons, taking into account differences in gestational age and other factors.
Using data from the retrospective, population-based Baltimore-Washington Infant Study, six types of congenital cardiovascular malformations were investigated in comparison with controls (n=3519) through linear regression: d-transposition of the great arteries (n=187), other conotruncal heart defects (n=361), endocardial cushion defects (n=281), left heart obstructive lesions (n=507), atrial septal defects (n=281), and membranous ventricular septal defects (n=622).
Infants with conotruncal heart defects (-218 g), endocardial cushion defects with Down syndrome (-265 g), endocardial cushion defects without Down syndrome (-194 g), left heart obstructive lesions (-143 g), atrial septal defects (-150 g), and membranous ventricular septal defects (-127 g) showed significant birth weight deficits, adjusting for gestational age, and other covariates. Infants with d-transposition of the great arteries (-67 g) did not show significant birth weight deficits compared with the control group.
The degree of birth weight decrement appears to be highly related to the specific type of congenital cardiovascular malformation. As a whole, these infants do not exhibit low birth weights solely because of being premature, and thus other mechanisms must underlie these associations.
先天性心血管畸形的一个已知合并症是低出生体重,但这种关联的原因仍不清楚。本回顾性研究考虑了胎龄差异和其他因素,探讨先天性心血管畸形与单胎出生体重之间的关系。
利用基于人群的回顾性巴尔的摩-华盛顿婴儿研究的数据,通过线性回归对六种先天性心血管畸形与对照组(n = 3519)进行了调查:大动脉d型转位(n = 187)、其他圆锥动脉干心脏缺陷(n = 361)、心内膜垫缺损(n = 281)、左心梗阻性病变(n = 507)、房间隔缺损(n = 281)和膜周部室间隔缺损(n = 622)。
在对胎龄和其他协变量进行调整后,患有圆锥动脉干心脏缺陷(-218克)、伴有唐氏综合征的心内膜垫缺损(-265克)、不伴有唐氏综合征的心内膜垫缺损(-194克)、左心梗阻性病变(-143克)、房间隔缺损(-150克)和膜周部室间隔缺损(-127克)的婴儿显示出显著的出生体重不足。与对照组相比,患有大动脉d型转位的婴儿(-67克)未显示出显著的出生体重不足。
出生体重下降的程度似乎与先天性心血管畸形的具体类型高度相关。总体而言,这些婴儿并非仅仅因为早产而表现出低出生体重,因此这些关联必然存在其他机制。