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妊娠间隔与出生缺陷。

Interpregnancy interval and birth defects.

作者信息

Mburia-Mwalili Adel, Yang Wei

机构信息

Environmental Sciences Graduate Program, University of Nevada, Reno, Nevada.

Office of Public Health Informatics and Epidemiology, Nevada Division of Public and Behavioral Health, Carson City, Nevada.

出版信息

Birth Defects Res A Clin Mol Teratol. 2015 Nov;103(11):904-12. doi: 10.1002/bdra.23420. Epub 2015 Sep 23.

Abstract

BACKGROUND

Interpregnancy interval is a risk factor for various adverse birth outcomes including birth defects. We investigated the relationship between interpregnancy interval and birth defects.

METHODS

We conducted a retrospective cohort study using linked data from Nevada Birth Outcomes Monitoring System and birth certificate data for 124,341 singleton live births, of which 4641 infants had 7192 birth defects, among Nevada resident women between 2006 and 2011. We used logistic regression to assess factors independently associated with birth defects.

RESULTS

Women who had an interpregnancy interval of 36 months or more, adjusted odds ratio (AOR) = 1.16, 95% confidence interval [CI], 1.01-1.33, were more likely to have an infant with a birth defect compared with women with an interpregnancy interval of 18 to 23 months. Other independent risk factors for birth defects included male infants, AOR = 1.34, 95% CI, 1.26-1.42; maternal age (30-34 years) and advanced maternal age (35 years and older), AOR = 1.10, 95% CI, 1.01-1.19 and AOR = 1.29, 95% CI, 1.18-1.42, respectively; being a Black woman, AOR = 1.46, 95% CI, 1.32-1.61; three and four or more previous births, AOR = 1.12, 95% CI, 1.02-1.23 and AOR = 1.24, 95% CI, 1.11-1.38, respectively; smoking, AOR = 1.23, 95% CI, 1.10-1.38; and prescription drug use, AOR = 1.14, 95% CI, 1.07-1.21.

CONCLUSION

A long interpregnancy interval is an independent risk factor for birth defects. It may be helpful for maternal and child health programs and health care providers to highlight the deleterious effects of a long interpregnancy interval.

摘要

背景

妊娠间隔是包括出生缺陷在内的各种不良出生结局的一个危险因素。我们调查了妊娠间隔与出生缺陷之间的关系。

方法

我们利用内华达州出生结局监测系统的关联数据和出生证明数据,对2006年至2011年内华达州常住妇女的124,341例单胎活产进行了一项回顾性队列研究,其中4641名婴儿有7192例出生缺陷。我们使用逻辑回归来评估与出生缺陷独立相关的因素。

结果

与妊娠间隔为18至23个月的妇女相比,妊娠间隔为36个月或更长时间的妇女,校正比值比(AOR)=1.16,95%置信区间[CI]为1.01-1.33,其婴儿患出生缺陷的可能性更大。出生缺陷的其他独立危险因素包括男婴,AOR=1.34,95%CI为1.26-1.42;母亲年龄(30-34岁)和高龄产妇(35岁及以上),AOR分别为1.10,95%CI为1.01-1.19和AOR=1.29,95%CI为1.18-1.42;黑人女性,AOR=1.46,95%CI为1.32-1.61;既往有3次及4次或更多次分娩,AOR分别为1.12,95%CI为1.02-1.23和AOR=1.24,95%CI为1.11-1.38;吸烟,AOR=1.23,95%CI为1.10-1.38;以及使用处方药,AOR=1.14,95%CI为1.07-1.21。

结论

较长的妊娠间隔是出生缺陷的一个独立危险因素。强调较长妊娠间隔的有害影响可能有助于母婴健康项目和医疗服务提供者。

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