Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Jul 19;36(28):e183. doi: 10.3346/jkms.2021.36.e183.
BACKGROUND: The prevalence of congenital anomalies in newborns in South Korea was 272.9 per 100,000 in 2005, and 314.7 per 100,000 in 2006. In other studies, the prevalence of congenital anomalies in South Korea was equivalent to 286.9 per 10,000 livebirths in 2006, while it was estimated 446.3 per 10,000 births during the period from 2008 to 2014. Several systematic reviews and meta-analyses analyzing the factors contributing to congenital anomalies have been reported, but comprehensive umbrella reviews are lacking. METHODS: We searched PubMed, Google Scholar, Cochrane, and EMBASE databases up to July 1, 2019, for systematic reviews and meta-analyses that investigated the effects of environmental and genetic factors on any type of congenital anomalies. We categorized 8 subgroups of congenital anomalies classified according to the 10th revision of the International Statistical Classification of Diseases (ICD-10). Two researchers independently searched the literature, retrieved the data, and evaluated the quality of each study. RESULTS: We reviewed 66 systematic reviews and meta-analyses that investigated the association between non-genetic or genetic risk factors and congenital anomalies. Overall, 269 associations and 128 associations were considered for environmental and genetic risk factors, respectively. Congenital anomalies based on congenital heart diseases, cleft lip and palate, and others were associated with environmental risk factors based on maternal exposure to environmental exposures (air pollution, toxic chemicals), parental smoking, maternal history (infectious diseases during pregnancy, pregestational and gestational diabetes mellitus, and gestational diabetes mellitus), maternal obesity, maternal drug intake, pregnancy through artificial reproductive technologies, and socioeconomic factors. The association of maternal alcohol or coffee consumption with congenital anomalies was not significant, and maternal folic acid supplementation had a preventive effect on congenital heart defects. Genes or genetic loci associated with congenital anomalies included , and , , , , , and 1p22 and 20q12 anomalies. CONCLUSION: This study provides a wide perspective on the distribution of environmental and genetic risk factors of congenital anomalies, thus suggesting future studies and providing health policy implications.
背景:2005 年,韩国新生儿先天性畸形的患病率为每 10 万人 272.9 例,2006 年为每 10 万人 314.7 例。在其他研究中,2006 年韩国先天性畸形的患病率相当于每 10000 例活产儿 286.9 例,而 2008 年至 2014 年期间估计为每 10000 例出生 446.3 例。已经有几项系统评价和荟萃分析报告了导致先天性畸形的因素,但缺乏全面的伞式综述。
方法:我们检索了 PubMed、Google Scholar、Cochrane 和 EMBASE 数据库,截至 2019 年 7 月 1 日,以获取系统评价和荟萃分析,这些研究调查了环境和遗传因素对任何类型先天性畸形的影响。我们根据国际疾病分类第 10 次修订版(ICD-10)将先天性畸形分为 8 个亚组。两名研究人员独立搜索文献、检索数据并评估每项研究的质量。
结果:我们综述了 66 项系统评价和荟萃分析,这些分析调查了非遗传或遗传危险因素与先天性畸形之间的关系。总体而言,分别有 269 项和 128 项关联被认为与环境和遗传危险因素有关。基于先天性心脏病、唇腭裂和其他先天性畸形的先天性畸形与基于母体暴露于环境暴露(空气污染、有毒化学物质)、父母吸烟、母体病史(妊娠期间传染病、孕前和妊娠期糖尿病以及妊娠期糖尿病)、母体肥胖、母体药物摄入、通过人工生殖技术妊娠和社会经济因素的环境危险因素有关。母体饮酒或咖啡摄入与先天性畸形的关联不显著,母体叶酸补充对先天性心脏病有预防作用。与先天性畸形相关的基因或遗传位点包括 1p36.33、2q37.3、3q29、10q26.3、16p13.11、16q22.1、17q21.31 和 1p22 和 20q12 异常。
结论:本研究从广泛的角度探讨了先天性畸形的环境和遗传危险因素的分布,从而为未来的研究提供了方向,并为卫生政策提供了启示。
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