Li D K, Daling J R
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.
Paediatr Perinat Epidemiol. 1993 Jul;7(3):253-62. doi: 10.1111/j.1365-3016.1993.tb00403.x.
It has been reported that parental human leukocyte antigen (HLA) compatibility is associated with certain adverse reproductive outcomes such as multiple spontaneous fetal losses and malformations, particularly among women without a prior livebirth. In order to study the relation between parental HLA compatibility and the risk of SIDS, a population-based case-control study was conducted using 1982-1990 Washington State linked birth and death certificate data. Concordance of parental race/ethnicity combined with prior maternal fetal loss was used as surrogate measures of parental HLA compatibility. The relation was evaluated separately among infants with and without a prior live-born sibling. Among first liveborn infants, those of racially discordant parents were at reduced risk of SIDS compared with those of racially concordant parents (relative risk [RR] = 0.57, 95% confidence interval = 0.34-0.96). Infants of white-minority parents were all at lower risk of SIDS than infants of white-white parents. Infants of racially concordant parents with two or more prior fetal losses were at increased risk of SIDS (RR = 2.44, 1.07-5.56), relative to infants of racially discordant parents. No such associations were observed among infants with prior live-born siblings. In fact, in this latter population, infants of racially concordant parents tended to have a lower risk of SIDS than those of discordant parents. This study suggests that a portion of SIDS cases, particularly among first live-born infants, may be due to parental HLA sharing. However, final determination of the existence of this relationship requires actual HLA typing of parents of both cases and controls.
据报道，父母的人类白细胞抗原（HLA）相容性与某些不良生殖结局相关，如多次自然流产和胎儿畸形，尤其是在之前没有活产的女性中。为了研究父母HLA相容性与婴儿猝死综合征（SIDS）风险之间的关系，利用1982 - 1990年华盛顿州出生与死亡证明关联数据进行了一项基于人群的病例对照研究。父母种族/族裔的一致性以及母亲先前的胎儿丢失情况被用作父母HLA相容性的替代指标。分别在有和没有活产同胞的婴儿中评估这种关系。在第一胎活产婴儿中，种族不一致的父母所生婴儿患SIDS的风险低于种族一致的父母所生婴儿（相对风险[RR]=0.57，95%置信区间=0.34 - 0.96）。白人 - 少数族裔父母所生婴儿患SIDS的风险均低于白人 - 白人父母所生婴儿。与种族不一致的父母所生婴儿相比，有两次或更多次先前胎儿丢失的种族一致的父母所生婴儿患SIDS的风险增加（RR = 2.44，1.07 - 5.56）。在有活产同胞的婴儿中未观察到此类关联。事实上，在这后一组人群中，种族一致的父母所生婴儿患SIDS的风险往往低于种族不一致的父母所生婴儿。这项研究表明，一部分SIDS病例，尤其是在第一胎活产婴儿中，可能是由于父母HLA共享。然而，要最终确定这种关系的存在，需要对病例组和对照组的父母进行实际的HLA分型。
