Baer Rebecca J, Chambers Christina D, Jones Kenneth Lyons, Shew Stephen B, MacKenzie Tippi C, Shaw Gary M, Jelliffe-Pawlowski Laura L
Genetic Disease Screening Program, California Department of Public Health, Richmond, California.
Department of Pediatrics, University of California San Diego, La Jolla, California.
Am J Med Genet A. 2015 Jul;167(7):1534-41. doi: 10.1002/ajmg.a.37016. Epub 2015 Apr 25.
We sought to identify age group specific maternal risk factors for gastroschisis. Maternal characteristics and prenatal factors were compared for 1,279 live born infants with gastroschisis and 3,069,678 without. Data were obtained using the California database containing linked hospital discharge, birth certificate and death records from 1 year prior to the birth to 1 year after the birth. Backwards-stepwise logistic regression models were used with maternal factors where initial inclusion was determined by a threshold of p < 0.10 on initial crude analyses. Due to the strong association of gastroschisis with young maternal age, models were stratified by age groups and odds ratios were calculated. These final models identified maternal infection as the only risk factor common to all age groups and a protective effect of obesity and gestational hypertension. In addition, age specific risk factors were identified. Although gestation at the time of infection was not available, a sexually transmitted disease complicating pregnancy was associated with increased risk in the less than 20 years of age grouping whereas viral infection was associated with increased risk only in the 20-24 and more than 24 years of age groupings. Urinary tract infection remained in the final logistic model for women less than 20 years. Short interpregnancy interval was not found to be a risk factor for any age group. Our findings support the need to explore maternal infection by type and gestational timing.
我们试图确定腹裂特定年龄组的孕产妇风险因素。比较了1279例腹裂活产婴儿和3069678例非腹裂活产婴儿的孕产妇特征和产前因素。数据来自加利福尼亚数据库，该数据库包含从出生前1年到出生后1年的医院出院记录、出生证明和死亡记录。采用向后逐步逻辑回归模型，将孕产妇因素纳入其中，初始纳入标准是在初步粗分析中p<0.10。由于腹裂与年轻孕产妇年龄密切相关，模型按年龄组分层并计算比值比。这些最终模型确定孕产妇感染是所有年龄组共有的唯一风险因素，肥胖和妊娠期高血压具有保护作用。此外，还确定了特定年龄的风险因素。虽然感染时的孕周数据不可用，但妊娠合并性传播疾病与20岁以下年龄组的风险增加有关，而病毒感染仅与20-24岁和24岁以上年龄组的风险增加有关。尿路感染仍在20岁以下女性的最终逻辑模型中。未发现短生育间隔对任何年龄组都是风险因素。我们的研究结果支持有必要按类型和妊娠时间探索孕产妇感染情况。
