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墨西哥西部婴儿孤立性先天性心脏缺陷的危险因素。

Risk factors for isolated congenital heart defects in infants from Western Mexico.

作者信息

Cruz-Cruz Jessica Paola, Nieto-García Rafael, Rivera-Ramírez Pascuala Berenice, Peña-Padilla Christian, Bobadilla-Morales Lucina, Corona-Rivera Alfredo, Rodríguez-Machuca Víctor Ulises, Valdez-Muñoz Sandra Rocio, Corona-Rivera Jorge Román

机构信息

Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Jalisco, Mexico.

Dr. Enrique Corona-Rivera Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.

出版信息

Congenit Anom (Kyoto). 2025 Jan-Dec;65(1):e12589. doi: 10.1111/cga.12589.

Abstract

Congenital heart defects (CHDs) are caused by a complex interaction between numerous genetic and environmental risk factors, some of which may differ between different populations. A case-control study was conducted among 1232 newborns, including 308 patients with isolated CHDs (cases) and 924 infants without birth defects (controls), born all during the period 2009-2023 at the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" (Guadalajara, Mexico). Potential parental risk factors for CHDs were compared using multivariate logistic regression analysis to evaluate the deviance explained by different variables of interest. Consanguinity [adjusted odds ratio (aOR) = 3.3; 95% confidence interval (CI) 1.3-8.5], relatives with CHD (aOR = 8.5; 95% CI 5.3-13.8), maternal first-trimester exposure to diabetes (aOR = 3.5; 95% CI 2.4-5.1), hypertension (aOR = 2.6; 95% CI 1.5-4.4), alcohol consumption (aOR = 1.5; 95% CI 1.0-2.1), and illicit drug use (aOR = 2.4; 95% CI 1.2-5.3), as well as for the paternal history of alcohol consumption (aOR = 1.4; 95% CI 1.0-1.8) and illicit drug use (aOR = 2.7; 95% CI 1.7-4.1), were associated with CHDs. Contrarily, aOR for maternal age ≤19 years (aOR = 0.6; 95% CI 0.4-0.8) and maternal first-trimester coffee consumption (aOR = 0.7; 95% CI 0.5-0.9) have protective odds. Our results suggest that genetic factors, maternal diseases, environmental exposures, and reproductive factors can increase the occurrence of isolated CHDs in our sample, and they are discussed as clues in its pathogenesis.

摘要

先天性心脏病(CHD)是由众多遗传和环境风险因素之间复杂的相互作用引起的,其中一些因素在不同人群中可能有所不同。在瓜达拉哈拉“胡安·I·门查卡博士”市民医院(墨西哥瓜达拉哈拉)对1232名新生儿进行了一项病例对照研究,其中包括308例孤立性先天性心脏病患者(病例组)和924例无出生缺陷的婴儿(对照组),这些婴儿均于2009年至2023年期间出生。使用多因素逻辑回归分析比较先天性心脏病潜在的父母风险因素,以评估不同感兴趣变量所解释的偏差。近亲结婚(调整后的优势比[aOR]=3.3;95%置信区间[CI]为1.3 - 8.5)、患有先天性心脏病的亲属(aOR = 8.5;95% CI为5.3 - 13.8)、母亲孕早期患糖尿病(aOR = 3.5;95% CI为2.4 - 5.1)、高血压(aOR = 2.6;95% CI为1.5 - 4.4)、饮酒(aOR = 1.5;95% CI为1.0 - 2.1)和使用非法药物(aOR = 2.4;95% CI为1.2 - 5.3),以及父亲的饮酒史(aOR = 1.4;95% CI为1.0 - 1.8)和使用非法药物史(aOR = 2.7;95% CI为1.7 - 4.1),均与先天性心脏病有关。相反,母亲年龄≤19岁(aOR = 0.6;95% CI为0.4 - 0.8)和母亲孕早期喝咖啡(aOR = 0.7;95% CI为0.5 - 0.9)具有保护优势。我们的研究结果表明,遗传因素、母亲疾病、环境暴露和生殖因素可增加我们样本中孤立性先天性心脏病的发生率,并且它们被作为其发病机制的线索进行讨论。

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