Katlaps Isabel, Ronai Christina, Garg Bharti, Mandelbaum Ava, Ghafari-Saravi Afsoon, Caughey Aaron B, Madriago Erin
Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
JACC Adv. 2024 Jun 1;3(7):101009. doi: 10.1016/j.jacadv.2024.101009. eCollection 2024 Jul.
Prior literature has described an association between preeclampsia and offspring congenital heart disease (CHD), while suggesting there may be a stronger relationship in individuals with early preeclampsia.
The authors sought to explore the relationship between offspring CHD and preeclampsia among pregnancies in a population-based study.
Retrospective cohort study all singleton pregnancies delivered in the state of California 2000 to 2012. We included singleton births with gestational ages of 23 to 42 weeks and excluded pregnancies complicated by pre-existing diabetes or identified fetal chromosomal anomalies. We used multivariable logistic regression to estimate ORs for associations between offspring CHD and preeclampsia. Further subanalyses examined the relationships in deliveries <34 weeks and >34 weeks to analyze if there was a difference according to timing of preeclampsia development.
Preeclampsia was strongly associated with offspring CHD (aOR: 1.38; 99% CI: 1.29-1.49) in the same pregnancy. Among patients with preeclampsia in the index pregnancy, there was an increased risk of fetal CHD in the subsequent pregnancy (aOR: 1.39; 99% CI: 1.20-1.61). Among patients with offspring CHD in the index pregnancy, there was an increased risk of preeclampsia in the subsequent pregnancy (aOR: 1.39; 99% CI: 1.15-1.68). In all 3 analyses, results remained significant when stratified by <34 weeks and ≥34 weeks.
Our findings suggest a need for further investigation into the etiology of preeclampsia and its relationship to embryologic development of cardiovascular structures.
既往文献描述了子痫前期与子代先天性心脏病（CHD）之间的关联，同时提示早发型子痫前期患者中二者关系可能更强。
作者试图在一项基于人群的研究中探讨子代CHD与子痫前期之间的关系。
对2000年至2012年在加利福尼亚州分娩的所有单胎妊娠进行回顾性队列研究。我们纳入了孕龄为23至42周的单胎分娩，并排除了合并孕前糖尿病或已确诊胎儿染色体异常的妊娠。我们使用多变量逻辑回归来估计子代CHD与子痫前期之间关联的比值比（OR）。进一步的亚组分析研究了孕周<34周和≥34周分娩中的关系，以分析子痫前期发生时间是否存在差异。
子痫前期与同一妊娠中的子代CHD密切相关（校正后OR：1.38；99%可信区间：1.29 - 1.49）。在本次妊娠患有子痫前期的患者中，后续妊娠胎儿患CHD的风险增加（校正后OR：1.39；99%可信区间：1.20 - 1.61）。在本次妊娠子代患有CHD的患者中，后续妊娠子痫前期的风险增加（校正后OR：1.39；99%可信区间：1.15 - 1.68）。在所有三项分析中，按孕周<34周和≥34周分层时结果仍具有显著性。
我们的研究结果表明，需要进一步调查子痫前期的病因及其与心血管结构胚胎发育的关系。
