Hurt Lisa, Uzun Orhan, Morris Susan, Bethel Jackie, Evans Annette, Seaborne Michael, Daniel Rhian, Brophy Sinead, Paranjothy Shantini
Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
University Hospital of Wales, Cardiff and Vale University Health Board, Heath Park Way, Cardiff CF14 4XW, UK.
Children (Basel). 2023 Jul 17;10(7):1233. doi: 10.3390/children10071233.
There is uncertainty about outcomes associated with cardiac echogenic foci (CEF) seen at the midtrimester ultrasound scan because of limited population-based follow-up data. This can lead to unnecessary invasive testing and significant parental anxiety. We analysed data from a cohort study, The Welsh Study of Mothers and Babies, to examine whether children with CEF had more adverse outcomes during childhood compared with children without CEF. Children born between 1 January 2009 and 31 December 2011 were followed until 31 January 2018, migration out of Wales, or death. The primary outcome was cardiac hospital admissions, defined a priori by an expert steering group. Secondary outcomes included congenital cardiac anomalies, and hospital admissions for other causes. There was no evidence of an association between isolated CEF and cardiac hospital admissions (hazard ratio 0.87, 95% confidence interval [CI] 0.33-2.25, value 0.768), or with congenital cardiac anomalies. There was a small increased risk of a respiratory admission with isolated CEF (hazard ratio 1.27, 95% CI 1.04-1.54, value 0.020). Further research is needed on features of CEF, such as location or number, to fully understand the clinical significance of these findings.
由于基于人群的随访数据有限，孕中期超声扫描发现的心脏强回声光斑（CEF）相关的结局存在不确定性。这可能导致不必要的侵入性检查以及家长的严重焦虑。我们分析了一项队列研究——威尔士母婴研究的数据，以检查与无CEF的儿童相比，有CEF的儿童在童年期是否有更多不良结局。对2009年1月1日至2011年12月31日出生的儿童进行随访，直至2018年1月31日、迁出威尔士或死亡。主要结局是心脏疾病住院，由一个专家指导小组预先定义。次要结局包括先天性心脏异常以及其他原因导致的住院。没有证据表明孤立性CEF与心脏疾病住院（风险比0.87，95%置信区间[CI] 0.33 - 2.25，P值0.768）或先天性心脏异常之间存在关联。孤立性CEF有轻微增加的呼吸系统住院风险（风险比1.27，95% CI 1.04 - 1.54，P值0.020）。需要对CEF的特征，如位置或数量，进行进一步研究，以充分了解这些发现的临床意义。
