Clinical Genetics and Dysmorphology, Cedars-Sinai Medical Center and Harbor-UCLA Medical Center, Professor Emeritus of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Birth Defects Res. 2020 Jul 15;112(12):943-952. doi: 10.1002/bdr2.1696.
I plan to review the types of defects caused by gestational hyperthermia. Hyperthermia-induced malformations in animals and humans involve many organs and structures, particularly the central nervous system, as well as other defects. The type of defect is related to the timing of the hyperthermic insult, and the underlying mechanisms include cell death, membrane disruption, vascular disruption, and placental infarction.
Review of recent epidemiologic studies (2005-2020) has confirmed an association between gestational hyperthermia and birth defects.
There are strong associations between neural tube defects and maternal fever, and other studies have demonstrated associations between first trimester hyperthermia and an increased risk for cardiovascular defects, oral clefts, isolated congenital ear defects, cataracts, hypospadias, renal anomalies, possibly anorectal malformations, and congenital anomalies in general, suggesting that this association between maternal hyperthermia and birth defects in humans is causal. The first prospective evaluation of maternal fever was reported in 1998, and this study confirmed findings from previous case-control studies and case series regarding the magnitude and duration of elevated maternal body temperature in relation to an increased risk for neural tube defects as well as a specific pattern of malformation.
The consistency of findings across these different study designs supports the causal nature of the relationship between maternal fever and specific birth defects. This review summarizes the recent human evidence documenting the gestational effects of maternal hyperthermia.
我计划回顾由妊娠期发热引起的缺陷类型。动物和人类因发热而导致的畸形涉及许多器官和结构，特别是中枢神经系统以及其他缺陷。缺陷的类型与发热损伤的时间有关，其潜在机制包括细胞死亡、膜破裂、血管破裂和胎盘梗死。
对最近（2005-2020 年）的流行病学研究进行了综述，证实了妊娠期发热与出生缺陷之间存在关联。
母体发热与神经管缺陷之间存在很强的关联，其他研究表明，孕早期发热与心血管缺陷、唇腭裂、孤立性先天性耳部缺陷、白内障、尿道下裂、肾脏异常、可能的肛门直肠畸形以及一般的先天性畸形风险增加之间存在关联，这表明母体发热与人类出生缺陷之间的这种关联是因果关系。1998 年首次对母体发热进行了前瞻性评估，该研究证实了之前病例对照研究和病例系列研究的发现，即母体体温升高的幅度和持续时间与神经管缺陷风险增加以及特定的畸形模式有关。
这些不同研究设计的结果的一致性支持母体发热与特定出生缺陷之间的因果关系。本综述总结了最近记录母体发热对妊娠影响的人类证据。
