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部分重大出生缺陷流行趋势:1999 至 2007 年美国多州基于人群的回顾性研究。

Prevalence trends of selected major birth defects: A multi-state population-based retrospective study, United States, 1999 to 2007.

机构信息

Congenital Malformations Registry, Center for Environmental Health, New York State Department of Health, Albany, New York.

Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

出版信息

Birth Defects Res. 2017 Nov 1;109(18):1442-1450. doi: 10.1002/bdr2.1113. Epub 2017 Sep 14.

Abstract

BACKGROUND

We evaluated selected birth defects over a 9-year period to assess prevalence trends by selected maternal and infant factors.

METHODS

Data were pooled from 11 population-based birth defects surveillance programs in the United States for children born between 1999 and 2007. Overall prevalence, as well as 3-year interval prevalence, was calculated for 26 specific birth defects, stratified by maternal age, maternal race/ethnicity, and infant sex. Average annual percent change (AAPC) was calculated for each birth defect. Poisson regression was used to determine change in AAPC, and joinpoint regression to identify breakpoints and changes in slope for prevalence of each defect over time.

RESULTS

Between 1999 and 2001 and 2005 and 2007, four birth defects increased by 10% or more: coarctation of the aorta (17%), gastroschisis (83%), omphalocele (11%), and Down syndrome (10%). Among mothers <20 years of age, the gastroschisis AAPC increased 10.1% overall and, cross-classified by maternal race/ethnicity, the AAPC for mothers <20 years increased 9.2%, 25.7%, and 7.7% among non-Hispanic white (NHW), non-Hispanic black (NHB), and Hispanic mothers, respectively. A small increase in Down syndrome (AAPC 4.4%) was found for NHB mothers ≥35 years.

CONCLUSION

No significant trends in prevalence were identified for most birth defects. Gastroschisis prevalence increased significantly among NHW and NHB mothers <20 years of age, with the greatest increases in NHB mothers. Prevalence of Down syndrome among NHB mothers ≥35 years also increased slightly. Stratified results may suggest avenues of research in birth defect etiology and in evaluating prevention efforts. Birth Defects Research 109:1442-1450, 2017.© 2017 Wiley Periodicals, Inc.

摘要

背景

我们评估了 9 年来的部分出生缺陷,以评估特定母婴因素对流行趋势的影响。

方法

数据来源于美国 11 个基于人群的出生缺陷监测项目,涉及 1999 年至 2007 年间出生的儿童。我们计算了 26 种特定出生缺陷的总体流行率和 3 年间隔流行率,并按母亲年龄、母亲种族/民族和婴儿性别进行分层。我们计算了每种出生缺陷的年平均百分比变化(AAPC)。我们采用泊松回归来确定 AAPC 的变化,采用联合点回归来确定每个缺陷的流行率随时间变化的转折点和斜率变化。

结果

在 1999 年至 2001 年和 2005 年至 2007 年期间,有 4 种出生缺陷的流行率增加了 10%或更多:主动脉缩窄(17%)、腹裂(83%)、脐膨出(11%)和唐氏综合征(10%)。在 20 岁以下的母亲中,腹裂的 AAPC 总体增加了 10.1%,按母亲种族/民族交叉分类,20 岁以下的非西班牙裔白种人(NHW)、非西班牙裔黑种人(NHB)和西班牙裔母亲的 AAPC 分别增加了 9.2%、25.7%和 7.7%。NHB 母亲中唐氏综合征的流行率略有增加(AAPC 为 4.4%),年龄在 35 岁以上。

结论

大多数出生缺陷的流行率没有明显趋势。NHW 和 NHB 20 岁以下母亲的腹裂流行率显著增加,其中 NHB 母亲的增加幅度最大。NHB 母亲中唐氏综合征的流行率也略有增加。分层结果可能提示了出生缺陷病因学和评估预防措施方面的研究途径。《出生缺陷研究》109:1442-1450,2017。© 2017 Wiley Periodicals, Inc.

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