Institut national de santé publique du Québec, Montreal, Quebec, Canada2Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada3University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.
University of Montreal Hospital Research Centre, Montreal, Quebec, Canada4Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada.
JAMA. 2015 Oct 20;314(15):1588-98. doi: 10.1001/jama.2015.12505.
The risk of congenital heart defects in infants of women who had preeclampsia during pregnancy is poorly understood, despite shared angiogenic pathways in both conditions.
To determine the prevalence of congenital heart defects in offspring of women with preeclampsia.
DESIGN, SETTING, AND PARTICIPANTS: Population-level analysis of live births before discharge, 1989-2012, was conducted for the entire province of Quebec, comprising a quarter of Canada's population. All women who delivered an infant with or without heart defects in any Quebec hospital were included (N = 1,942,072 neonates).
Preeclampsia or eclampsia with onset before or after 34 weeks of gestation.
Presence of any critical or noncritical congenital heart defect detected in infants at birth, comparing prevalence in those exposed and not exposed to preeclampsia.
The absolute prevalence of congenital heart defects was higher for infants of women with preeclampsia than those without it. Infants of women with preeclampsia had no increased prevalence of critical heart defects but did have an increased prevalence of noncritical heart defects compared with infants of nonpreeclamptic women. [table: see text]. Among specific defects, prevalence was greatest for septal defects. Compared with infants of women with late-onset preeclampsia, those with early onset (<34 weeks) had greater prevalence of critical heart defects (364.4/100,000 [20/5488]; prevalence ratio, 2.78; 95% CI, 1.71-4.50; prevalence difference, 249.6/100,000; 95%CI, 89.7-409.6) and noncritical heart defects (7306.9/100,000 [401/5488]; prevalence ratio, 5.55; 95%CI, 4.98-6.19; prevalence difference, 6089.2/100,000; 95%CI, 5350.0-6828.3).
In this population-based study, preeclampsia was significantly associated with noncritical heart defects in offspring, and preeclampsia before 34 weeks was associated with critical heart defects. However, the absolute risk of congenital heart defects was low.
尽管在这两种情况下都存在血管生成途径，但孕妇子痫前期患者所生婴儿的先天性心脏缺陷风险仍知之甚少。
确定子痫前期患者后代中先天性心脏缺陷的患病率。
设计、地点和参与者：对 1989 年至 2012 年期间在魁北克省所有医院分娩的活产儿进行了人群水平分析，该省占加拿大人口的四分之一。所有在魁北克省任何一家医院分娩的患有或不患有心脏缺陷的婴儿均纳入研究（N=1,942,072 名新生儿）。
在妊娠 34 周前或之后出现的子痫前期或子痫。
比较暴露和未暴露于子痫前期的婴儿出生时存在任何严重或非严重先天性心脏缺陷的患病率。
与没有子痫前期的婴儿相比，患有子痫前期的婴儿的先天性心脏缺陷绝对患病率更高。患有子痫前期的婴儿没有增加严重心脏缺陷的患病率，但与非子痫前期妇女的婴儿相比，患有非严重心脏缺陷的婴儿的患病率增加。[表：见正文]。在特定缺陷中，间隔缺损的患病率最高。与晚发型子痫前期患者的婴儿相比，早发型（<34 周）患者的严重心脏缺陷（364.4/100000[20/5488]；患病率比，2.78；95%CI，1.71-4.50；患病率差异，249.6/100000；95%CI，89.7-409.6）和非严重心脏缺陷（7306.9/100000[401/5488]；患病率比，5.55；95%CI，4.98-6.19；患病率差异，6089.2/100000；95%CI，5350.0-6828.3）的患病率更高。
在这项基于人群的研究中，子痫前期与后代的非严重心脏缺陷显著相关，34 周前的子痫前期与严重心脏缺陷相关。然而，先天性心脏缺陷的绝对风险较低。
