Williams C L, Strobino B, Weinstein A, Spierling P, Medici F
Child Health Center, American Health Foundation, Valhalla, New York 10595, USA.
Paediatr Perinat Epidemiol. 1995 Jul;9(3):320-30. doi: 10.1111/j.1365-3016.1995.tb00148.x.
This report describes a cohort study of over 5000 infants and their mothers who participated in a cord blood serosurvey designed to examine the relationship between maternal exposure to Lyme disease and adverse pregnancy outcome. Based on serology and reported clinical history, mothers of infants in an endemic hospital cohort are 5 to 20 times more likely to have been exposed to B. burgdorferi as compared with mothers of infants in a control hospital cohort. The incidence of total congenital malformations was not significantly different in the endemic cohort compared with the control cohort, but the rate of cardiac malformations was significantly higher in the endemic cohort [odds ratio (OR) 2.40; 95% confidence interval (CI) 1.25, 4.59] and the frequencies of certain minor malformations (haemangiomas, polydactyly, and hydrocele), were significantly increased in the control group. Demographic variations could only account for differences in the frequency of polydactyly. Within the endemic cohort, there were no differences in the rate of major or minor malformations or mean birthweight by category of possible maternal exposure to Lyme disease or cord blood serology. The disparity between observations at the population and individual levels requires further investigation. The absence of association at the individual level in the endemic area could be because of the small number of women who were actually exposed either in terms of serology or clinical history. The reason for the findings at the population level is not known but could be because of artifact or population differences.
本报告描述了一项队列研究，该研究涉及5000多名婴儿及其母亲，他们参与了一项脐血血清学调查，旨在研究母亲暴露于莱姆病与不良妊娠结局之间的关系。根据血清学检查和报告的临床病史，与对照医院队列中婴儿的母亲相比，地方性医院队列中婴儿的母亲感染伯氏疏螺旋体的可能性要高5至20倍。与对照队列相比，地方性队列中先天性畸形的总发生率没有显著差异，但地方性队列中心脏畸形的发生率显著更高[比值比（OR）2.40；95%置信区间（CI）1.25，4.59]，而某些轻微畸形（血管瘤、多指畸形和鞘膜积液）的发生率在对照组中显著增加。人口统计学差异只能解释多指畸形频率的差异。在地方性队列中，根据母亲可能接触莱姆病的类别或脐血血清学，严重或轻微畸形的发生率或平均出生体重没有差异。人群水平和个体水平观察结果之间的差异需要进一步研究。地方性地区个体水平上缺乏关联可能是因为实际在血清学或临床病史方面接触的女性数量较少。人群水平上这些发现的原因尚不清楚，但可能是由于假象或人群差异。
