Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Division of Reproductive, Stem Cell and Perinatal Biology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
Am J Epidemiol. 2018 Apr 1;187(4):668-676. doi: 10.1093/aje/kwx269.
To explore a potential association between preeclampsia and selected birth defects, we examined the prevalence of certain birth defects among women with hypertensive disorders including preeclampsia. We analyzed data from 2,499,536 singleton live births in California from 2007 to 2011, including maternal and infant demographics from birth certificates as well as clinical details from delivery hospitalization records. We examined defect groups that were recognizable at birth (e.g., spina bifida and cleft lip). Hypertensive disorders included preexisting hypertension, gestational hypertension, mild preeclampsia, severe preeclampsia/eclampsia, and preeclampsia superimposed on preexisting hypertension. Relative risk values with 95% confidence intervals for each birth defect were calculated by hypertensive group, as well as independent and joint associations of hypertensive and diabetic disorders. Risks of each type of birth defect were higher among offspring of women with hypertensive disorders compared with those without. The risks of birth defects among offspring of women with only a hypertensive disorder were significantly higher than that among women with neither hypertensive nor diabetic disorders (relative risks ranged from 1.37 to 2.77). Risks of birth defects were highest among those born to women with both hypertensive and diabetic disorders compared with those with neither (relative risks ranged from 1.80 to 6.22). These findings support the existence of an association between preeclampsia and certain birth defects and suggest that diabetes may be a contributing factor.
为了探索子痫前期与某些出生缺陷之间的潜在关联，我们检查了患有包括子痫前期在内的高血压疾病的女性中某些出生缺陷的患病率。我们分析了 2007 年至 2011 年加利福尼亚州 2,499,536 例单胎活产的数据，这些数据包括出生证明中的母婴人口统计学数据以及分娩住院记录中的临床详细信息。我们检查了在出生时可识别的缺陷组（例如脊柱裂和唇裂）。高血压疾病包括先前存在的高血压、妊娠期高血压、轻度子痫前期、重度子痫前期/子痫以及在先前存在的高血压基础上发生的子痫前期。通过高血压组计算了每个出生缺陷的相对风险值和 95%置信区间，以及高血压和糖尿病疾病的独立和联合关联。与没有高血压疾病的女性相比，患有高血压疾病的女性的后代发生出生缺陷的风险更高。仅患有高血压疾病的女性的后代发生出生缺陷的风险明显高于既无高血压也无糖尿病疾病的女性（相对风险范围为 1.37 至 2.77）。与既无高血压也无糖尿病疾病的女性相比，患有高血压和糖尿病疾病的女性的后代发生出生缺陷的风险最高（相对风险范围为 1.80 至 6.22）。这些发现支持子痫前期与某些出生缺陷之间存在关联，并表明糖尿病可能是一个促成因素。
