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成骨不全症的流行病学:欧洲的一项基于人群的研究。

Epidemiology of achondroplasia: A population-based study in Europe.

机构信息

Institute of Clinical Physiology, National Research Council, Pisa, Italy.

Paediatric Department, Hospital Lillebaelt, Kolding, Denmark.

出版信息

Am J Med Genet A. 2019 Sep;179(9):1791-1798. doi: 10.1002/ajmg.a.61289. Epub 2019 Jul 11.

Abstract

Achondroplasia is a rare genetic disorder resulting in short-limb skeletal dysplasia. We present the largest European population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. All cases of achondroplasia notified to 28 EUROCAT registries (1991-2015) were included in the study. Prevalence, birth outcomes, prenatal diagnosis, associated anomalies, and the impact of paternal and maternal age on de novo achondroplasia were presented. The study population consisted of 434 achondroplasia cases with a prevalence of 3.72 per 100,000 births (95%CIs: 3.14-4.39). There were 350 live births, 82 terminations of pregnancy after prenatal diagnosis, and two fetal deaths. The prenatal detection rate was significantly higher in recent years (71% in 2011-2015 vs. 36% in 1991-1995). Major associated congenital anomalies were present in 10% of cases. About 20% of cases were familial. After adjusting for maternal age, fathers >34 years had a significantly higher risk of having infants with de novo achondroplasia than younger fathers. Prevalence was stable over time, but regional differences were observed. All pregnancy outcomes were included in the prevalence estimate with 80.6% being live born. The study confirmed the increased risk for older fathers of having infants with de novo achondroplasia.

摘要

软骨发育不全症是一种罕见的遗传性疾病,导致短肢骨骼发育不良。我们利用欧洲出生缺陷监测(EUROCAT)网络提供的数据,开展了迄今为止最大的基于欧洲人群的流行病学研究。研究纳入了 28 个 EUROCAT 注册中心(1991-2015 年)报告的所有软骨发育不全症病例。本研究介绍了患病率、出生结局、产前诊断、相关畸形以及父、母亲年龄对新发软骨发育不全症的影响。研究人群包括 434 例软骨发育不全症病例,患病率为 3.72/10 万(95%CI:3.14-4.39)。活产 350 例,产前诊断后终止妊娠 82 例,胎儿死亡 2 例。近年来产前检出率显著增高(2011-2015 年为 71%,1991-1995 年为 36%)。10%的病例存在主要的先天性畸形。约 20%的病例为家族性。校正母亲年龄后,父亲年龄>34 岁的新生儿发生新发软骨发育不全症的风险明显高于年轻父亲。患病率随时间稳定,但存在地域差异。所有妊娠结局均包含在患病率估计中,活产率为 80.6%。本研究证实了父亲年龄越大,新生儿发生新发软骨发育不全症的风险越高。

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