Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China.
Sci Rep. 2019 Jan 24;9(1):589. doi: 10.1038/s41598-018-36968-y.
The purpose of this study was to explore the association between colds, depressive symptoms during pregnancy and offspring congenital heart disease (CHD). A 1:2 matching case-control study was conducted in Northwest China. Information was gathered by a structured questionnaire and was reviewed by investigators on the spot. Multivariate logistic regressions and nonlinear mixed effect model were performed. 614 cases and 1228 controls were available in this study. After adjusting for potential confounders, the colds during the entire pregnancy were associated with increased risk of offspring CHD (OR = 1.44(1.12-1.85)). Similarly, there was a higher depression score in CHD group than the control group (OR = 1.89(1.48-2.41)). In addition, the women with both colds and higher depression scores had a higher risk of offspring CHD (OR = 2.72(1.87-3.93)) than their counterparts with only colds (OR = 1.48(1.04-2.09)) or with only higher depression scores (OR = 1.94(1.37-2.74)). The combined effects were significant in the multiplication model (OR = 2.04(1.47-2.83)) but not in the additive model (S = 1.40(0.70-2.81), AP = 0.19(-0.15-0.53) and RERI = 0.55(-0.54-1.64)). In conclusion, the colds and depressive symptoms during pregnancy were found associated with increased risk of offspring CHD and we found for the first time that there existed a statistically multiplying interaction effect of colds and depression on increasing risk of offspring CHD.
本研究旨在探讨孕期感冒与孕妇抑郁症状与子代先天性心脏病（CHD）之间的关联。本研究采用 1:2 配比的病例对照研究方法，在中国西北地区进行。通过结构化问卷收集信息，并由研究人员现场审核。采用多变量逻辑回归和非线性混合效应模型进行分析。本研究共纳入 614 例病例和 1228 例对照。在调整了潜在混杂因素后，整个孕期感冒与子代 CHD 的发病风险增加相关（OR=1.44（1.12-1.85））。同样，CHD 组的抑郁评分高于对照组（OR=1.89（1.48-2.41））。此外，与仅有感冒（OR=1.48（1.04-2.09））或仅有更高抑郁评分（OR=1.94（1.37-2.74））的孕妇相比，同时患有感冒和更高抑郁评分的孕妇其子代 CHD 的发病风险更高（OR=2.72（1.87-3.93））。在乘法模型中，联合效应具有统计学意义（OR=2.04（1.47-2.83）），但在加法模型中不具有统计学意义（S=1.40（0.70-2.81），AP=0.19（-0.15-0.53）和 RERI=0.55（-0.54-1.64））。综上所述，孕期感冒和抑郁症状与子代 CHD 的发病风险增加相关，本研究首次发现感冒和抑郁对增加子代 CHD 发病风险存在统计学相乘交互作用。
