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受孕前后父母的状况与子代的膜周部室间隔缺损

Periconceptional parental conditions and perimembranous ventricular septal defects in the offspring.

作者信息

Wijnands Kim P J, Zeilmaker Gerda A, Meijer Willemijn M, Helbing Willem A, Steegers-Theunissen Régine P M

机构信息

Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

出版信息

Birth Defects Res A Clin Mol Teratol. 2014 Dec;100(12):944-50. doi: 10.1002/bdra.23265. Epub 2014 Sep 5.

Abstract

BACKGROUND

The perimembranous ventricular septal (pVSD) defect is the most common congenital heart disease phenotype. Several parental factors are associated with pVSD risk in the offspring. To contribute to the future prevention of pVSDs, we investigated associations with nongenetic parental conditions.

METHODS

In a case-control study with standardized data collection at 17 months after birth, 115 parents of a child with pVSD and 484 parents of a healthy child completed questionnaires about periconceptional nongenetic conditions. Univariable and multivariable logistic regression analyses were used to estimate odds ratios (OR) with 95% confidence intervals (95% CI).

RESULTS

Complete data were available for 588 families (98%). Maternal risk conditions associated with pVSD offspring were a positive family history of congenital heart disease (OR, 2.61; 95%CI, 0.98-6.91), medication use (OR, 1.80; 95%CI, 1.13-2.85) and advanced age (OR, 1.07; 95%CI, 1.02-1.12). Exposure to phthalates (OR, 1.93; 95%CI, 1.05-3.54) was the only paternal risk condition associated with pVSD offspring.

CONCLUSION

Four periconceptional parental conditions contributed to pVSD risk in the offspring. Couples planning pregnancy should be counseled on these risk conditions which are partially modifiable to contribute to the future prevention of pVSDs.

摘要

背景

膜周部室间隔缺损(pVSD)是最常见的先天性心脏病表型。几种亲代因素与后代患pVSD的风险相关。为有助于未来预防pVSD,我们研究了与非遗传亲代状况的关联。

方法

在一项出生后17个月进行标准化数据收集的病例对照研究中,115名pVSD患儿的父母和484名健康儿童的父母完成了关于受孕前非遗传状况的问卷调查。采用单变量和多变量逻辑回归分析来估计比值比(OR)及95%置信区间(95%CI)。

结果

588个家庭(98%)有完整数据。与pVSD后代相关的母亲风险状况包括先天性心脏病家族史阳性(OR,2.61;95%CI,0.98 - 6.91)、用药情况(OR,1.80;95%CI,1.13 - 2.85)和高龄(OR,1.07;95%CI,1.02 - 1.12)。邻苯二甲酸盐暴露(OR,1.93;95%CI,1.05 - 3.54)是与pVSD后代相关的唯一父亲风险状况。

结论

四种受孕前亲代状况会增加后代患pVSD的风险。对于计划怀孕的夫妇,应就这些风险状况提供咨询,其中部分状况是可改变的,这有助于未来预防pVSD。

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