Bánhidy Ferenc, Ács Nándor, Puhó Erzsébet H, Czeizel Andrew E
Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary.
Foundation for the Community Control of Hereditary Diseases, Budapest, Hungary.
Am J Med Genet A. 2015 Aug;167A(8):1779-86. doi: 10.1002/ajmg.a.33759. Epub 2015 May 27.
The aim of the study was to estimate the possible association of pregnant women with paroxysmal supraventricular tachycardia (PSVT) with the possible risk for adverse birth outcomes, particularly different congenital abnormalities (CAs) in their children. Prospectively and medically recorded PSVT was evaluated in 103 pregnant women who later had offspring with CA (case group) and 149 pregnant women who later delivered newborn infants without CA (control group) and matched to cases in the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. Of 252 pregnant women with PSVT, 115 (45.6%) had the onset of this condition before the study pregnancy, that is, their PSVT was a chronic condition, while the rest (N = 137) of PSVT was considered as new onset in the study pregnancy. The comparison of occurrence of PSVT in pregnant women who had offspring with different CA groups and in control mothers showed a higher risk for cardiovascular CAs (adjusted OR with 95% CI: 2.1, 1.1-3.8) explained mainly by secundum atrial septal defect. This association was confirmed in pregnant women with PSVT in the second and/or third gestational month, that is, critical period of cardiovascular CAs. In conclusion PSVT in pregnant women associates with a higher risk of secundum atrial septal defect in their children.
本研究的目的是评估阵发性室上性心动过速(PSVT)的孕妇与不良分娩结局的潜在风险之间的可能关联,尤其是其子女出现不同先天性异常(CA)的风险。前瞻性地对医学记录的PSVT进行评估,研究对象为103名后来生育患有CA子女的孕妇(病例组)和149名后来分娩的新生儿无CA的孕妇(对照组),并与匈牙利先天性异常病例对照监测系统1980 - 1996年基于人群的数据集中的病例进行匹配。在252名患有PSVT的孕妇中,115名(45.6%)在本次研究妊娠前就已发病,即她们的PSVT为慢性病,而其余(N = 137)的PSVT被认为是本次研究妊娠期间新发病例。对生育不同CA组子女的孕妇和对照母亲中PSVT的发生率进行比较,结果显示心血管CA的风险更高(调整后的OR及95%CI:2.1,1.1 - 3.8),主要由继发孔房间隔缺损所致。在妊娠第二和/或第三个月(即心血管CA的关键时期)患有PSVT的孕妇中证实了这种关联。总之,孕妇的PSVT与其子女继发孔房间隔缺损的较高风险相关。