Bianchi F, Cianciulli D, Pierini A, Seniori Costantini A
Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, Pisa, Italy.
Occup Environ Med. 1997 Apr;54(4):223-8. doi: 10.1136/oem.54.4.223.
To investigate the relations between congenital malformations and maternal occupation during pregnancy with a registry based case-control study.
Analysis was performed on data derived from the Florence Eurocat registry surveillance programme. The study included cases with isolated conditions, including chromosomal anomalies (n = 1351), cases with multiple anomalies registered during the 1980-91 period (n = 440), and babies with no congenital malformations recognised at birth who were born from 1982 to 1989 and selected as controls (n = 3223). 11 categories were defined, 10 including cases with isolated malformations and one for cases with multiple congenital anomalies. Four categories of maternal occupation were selected for the study. Odds ratio (OR) values were adjusted for maternal origin, maternal and paternal education, number of previous live births, illness during pregnancy, and maternal age when the group of chromosomal anomalies was analysed.
A notable and significant association between oral clefts and mothers involved in leather and shoe manufacturing was found (adjusted OR 3.9; 99% confidence interval (99% CI) 1.5 to 9.8) and the risk consistently increased when considering cases with isolated cleft palate separately (OR 5.4; 95% CI 1.8 to 13.4). Moreover, a significant risk was identified for the association between multiple anomalies and textile dye workers (adjusted OR 1.9; 99% CI 1.0 to 3.8).
This study indicates a notable, significant relation between maternal occupation as a pelt or leather worker and orofacial clefts in offspring. This finding is in agreement with the suggested inheritance models. The dilution effect due to studying large and heterogeneous groups of workers and occupations limits the value of the study; but it provides a good example of the use of a large database to search for teratogenic risk with the aid of malformation registries.
通过一项基于登记处的病例对照研究，调查先天性畸形与孕期母亲职业之间的关系。
对源自佛罗伦萨欧洲先天性异常监测登记项目的数据进行分析。该研究纳入了患有单一病症的病例，包括染色体异常病例（n = 1351）、1980 - 1991年期间登记的患有多种异常的病例（n = 440），以及1982年至1989年出生且出生时未被识别出先天性畸形的婴儿作为对照（n = 3223）。定义了11个类别，其中10个类别包括患有单一畸形的病例，1个类别为患有多种先天性异常的病例。研究选取了四类母亲职业。在分析染色体异常病例组时，对优势比（OR）值进行了母亲籍贯、母亲和父亲教育程度、既往活产数、孕期疾病以及母亲年龄的校正。
发现唇腭裂与从事皮革和制鞋制造业的母亲之间存在显著关联（校正OR 3.9；99%置信区间（99%CI）1.5至9.8），当单独考虑单纯腭裂病例时，风险持续增加（OR 5.4；95%CI 1.8至13.4）。此外，还确定了多种异常与纺织染料工人之间存在显著风险关联（校正OR 1.9；99%CI 1.0至3.8）。
本研究表明，母亲作为毛皮或皮革工人的职业与后代口面部裂隙之间存在显著关系。这一发现与所提出的遗传模型一致。由于研究的工人和职业群体规模大且种类繁多而产生的稀释效应限制了该研究的价值；但它为利用大型数据库借助畸形登记处来寻找致畸风险提供了一个很好的范例。
