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阿根廷 160 万例出生中的先天性肢体减少缺陷。

Congenital limb reduction defects in 1.6 million births in Argentina.

机构信息

Department of Clinical Genetics, National Center of Medical Genetics (CNGM), National Administration of Laboratories and Health Institutes (ANLIS), National Ministry of Health, Buenos Aires, Argentina.

National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics (CNGM), National Administration of Laboratories and Health Institutes (ANLIS), National Ministry of Health, Buenos Aires, Argentina.

出版信息

Am J Med Genet A. 2020 May;182(5):1084-1092. doi: 10.1002/ajmg.a.61528. Epub 2020 Feb 29.

Abstract

The objectives of this study were to describe the birth prevalence of limb reduction defects (LRD) in Argentina, their clinical features, and to review the literature on this topic. The data source was the National Network of Congenital Anomalies of Argentina, a surveillance system that has been operative since 2009. Data were collected from November 1, 2009 to December 31, 2016. 1,663,610 births and 702 affected patients were registered during this period. The prevalence of LRD was 4.22/10,000 births (CI 95%: 3.93-4.54). In 15,094 stillbirths, prevalence was 30.80/10,000 (CI 95%: 22.31-40.65). Perinatal mortality (stillbirths plus early neonatal deaths) was 24.6%, mostly explained by postnatal deaths. LRD were classified according to different variables, including Gold's anatomic classification. Then, 41.0% of patients had transverse terminal defects and 50.2% had longitudinal defects. We found multiple and syndromic clinical presentation to be associated with both preaxial LRD and lethality. The prevalence of LRD was lower and perinatal mortality was higher in our study compared to that of previously published studies. Because there is heterogeneity in the inclusion and exclusion criteria among publications, a greater effort should be made in order to include similar populations and to use a unified anatomic classification and nomenclature.

摘要

本研究的目的是描述阿根廷肢体减少缺陷(LRD)的出生流行率、其临床特征,并回顾该主题的文献。数据源是阿根廷先天性畸形国家网络,这是一个自 2009 年以来运作的监测系统。数据收集时间为 2009 年 11 月 1 日至 2016 年 12 月 31 日。在此期间,登记了 1663610 例分娩和 702 例受影响患者。LRD 的患病率为 4.22/10000 例(95%CI:3.93-4.54)。在 15094 例死产中,患病率为 30.80/10000(95%CI:22.31-40.65)。围产儿死亡率(死产加早期新生儿死亡)为 24.6%,主要由产后死亡引起。LRD 根据不同的变量进行分类,包括 Gold 的解剖分类。然后,41.0%的患者有横向末端缺陷,50.2%有纵向缺陷。我们发现,多灶性和综合征性临床表现与前轴 LRD 和致死性有关。与之前发表的研究相比,本研究 LRD 的患病率较低,围产儿死亡率较高。由于出版物之间的纳入和排除标准存在异质性,因此应该做出更大的努力,以便纳入类似的人群,并使用统一的解剖分类和命名法。

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