Increased risk of birth defects among children from multiple births
Increased risk of birth defects among children from multiple births
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DOI：
10.1002/bdra.10093
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发表时间：
2003-10-01
影响因子：
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通讯作者：
Bodurtha, J
中科院分区：
文献类型：
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作者：
Li, SJ;Ford, N;Bodurtha, J
背景：多胎出生正在增加，可能与出生缺陷有关。方法：为了探索这种关系，分析了弗吉尼亚出生缺陷登记处（VaCARES）的数据。研究结果：在1989 - 1998年期间，弗吉尼亚州共有44，505名单胎分娩的儿童和2，258名多胎分娩的儿童出生缺陷。与单胎分娩相比，多胎分娩的儿童出生缺陷风险显著增加（每10，000例活产婴儿的出生缺陷率：单胎482.3，双胎922.0，三胎1300.0，四胎或以上2222.2）。86例诊断中有39例观察到风险增加。每10，000例活产婴儿中风险率最高的五种诊断是：神经纤维瘤病（RR，12.80）、晶状体后纤维增生（RR，9.96）、小眼球（RR，5.24）、肺动脉瓣异常（RR，5.00）和动脉导管未闭（RR，4.68）。在这些儿童中发现先天性髋关节脱位的风险比显著降低（RR，0.54）。在大多数多胞胎中，只有一个孩子出生时有出生缺陷（双胞胎81%，三胞胎71%，四胞胎和更高出生率56%）。对于所有兄弟姐妹都有出生缺陷的儿童，出生缺陷的诊断可能一致或不一致。多胎出生缺陷儿多为早产儿，出生体重明显偏低。还观察到较高的病死率和死亡率以及较长的住院时间。结论：总的来说，多胞胎的孩子有出生缺陷的风险增加。(C)2003 Wiley-Liss，Inc.
BACKGROUND: Multiple births are increasing, and may be associated with birth defects. METHODS: To explore this relationship, data from the Virginia birth defects registry (VaCARES) was analyzed. RESULTS: During 1989-1998, a total of 44,505 children from singleton births and 2258 children from multiple births were born with birth defects in Virginia. The risk of birth defects was significantly increased in children from multiple births as compared to singleton births (birth defect rate per 10,000 live births: singleton 482.3, twin 922.0, triplet 1300.0, and quadruplet or higher 2222.2). Increased risk was observed for 39 of 86 diagnoses. The five diagnoses with the highest risk ratio per 10,000 live births (RR) were: neurofibromatosis (RR, 12.80), retrolental fibroplasia (RR, 9.96), microphthalmos (RR, 5.24), pulmonary valve anomalies (RR, 5.00), and patent ductus arteriosus (RR, 4.68). A significantly reduced risk ratio for congenital hip dislocation was found in these children (RR, 0.54). In most multiple births, only one child was born with birth defects (81% in twin births, 71% in triplet births, and 56% in quadruplet and higher births). The diagnosis of birth defects might be concordant or discordant for children in which all siblings had birth defects. The children from multiple births who had birth defects were generally preterm and had significantly lower birth weight. A higher fatality and mortality rate and longer hospital stay were also observed. CONCLUSIONS: Overall, children from multiple births have an increased risk of birth defects. (C) 2003 Wiley-Liss, Inc.