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与先兆子痫家族史相关的缺血性胎盘疾病风险。

Risk of Ischemic Placental Disease in Relation to Family History of Preeclampsia.

机构信息

Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Joseph L. Mailman School of Public Health, Columbia University, New York, New York.

Department of Health Policy and Management, Joseph L. Mailman School of Public Health, Columbia University, New York, New York.

出版信息

Am J Perinatol. 2019 May;36(6):624-631. doi: 10.1055/s-0038-1672177. Epub 2018 Oct 3.

Abstract

OBJECTIVE

To assess the risk of ischemic placental disease (IPD) including preeclampsia, small for gestational age (SGA), and abruption, in relation to preeclampsia in maternal grandmother, mother, and sister(s).

STUDY DESIGN

We performed a secondary analysis of data from a randomized trial of vitamins C and E for preeclampsia prevention. Data on family history of preeclampsia were based on recall by the proband. The associations between family history of preeclampsia and the odds of IPD were evaluated from alternating logistic regressions.

RESULTS

Of the 9,686 women who delivered nonmalformed, singleton live births, 17.1% had IPD. Probands provided data on preeclampsia in 55.5% ( = 5,374) on all three family members, 26.5% ( = 2,562) in mother and sister(s) only, and 11.6% ( = 1,125) in sister(s) only. The pairwise odds ratio (pOR) of IPD was 1.16 (95% confidence interval [CI]: 1.00-1.36) if one or more of the female relatives had preeclampsia. The pORs of preeclampsia were 1.54 (95% CI: 1.12-2.13) and 1.35 (95% CI: 1.03-1.77) if the proband's mother or sister(s) had a preeclamptic pregnancy, respectively, but no associations were seen for SGA infant or abruption.

CONCLUSION

This study suggests that IPD may share a predisposition with preeclampsia, suggesting a familial inheritance.

摘要

目的

评估与子痫前期相关的缺血性胎盘疾病(IPD),包括子痫前期、胎儿生长受限(SGA)和胎盘早剥的风险,与外祖母、母亲和姐妹(s)的子痫前期有关。

研究设计

我们对维生素 C 和 E 预防子痫前期的随机试验数据进行了二次分析。家族史子痫前期的数据基于先证者的回忆。通过交替逻辑回归评估家族史子痫前期与 IPD 比值比(OR)的关系。

结果

在 9686 名分娩非畸形、单胎活产的妇女中,17.1%患有 IPD。55.5%(=5374)的先证者提供了所有三个家庭成员的子痫前期数据,26.5%(=2562)仅提供了母亲和姐妹(s)的数据,11.6%(=1125)仅提供了姐妹(s)的数据。如果一个或多个女性亲属患有子痫前期,IPD 的配对比值比(OR)为 1.16(95%置信区间[CI]:1.00-1.36)。如果先证者的母亲或姐妹(s)患有子痫前期,子痫前期的 OR 分别为 1.54(95%CI:1.12-2.13)和 1.35(95%CI:1.03-1.77),但 SGA 婴儿或胎盘早剥均无相关性。

结论

本研究表明,IPD 可能与子痫前期具有共同的易感性,提示存在家族遗传。

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