Physical exposures during pregnancy and congenital cardiovascular malformations
Physical exposures during pregnancy and congenital cardiovascular malformations
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DOI：
10.1111/j.1365-3016.2004.00586.x
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发表时间：
2004-09-01
影响因子：
2.8
通讯作者：
Marshall, EG
中科院分区：
文献类型：
--
作者：
Judge, CM;Chasan-Taber, L;Marshall, EG
先天性心血管畸形（CCM）导致新生儿发病率和死亡率很高。CCM的已知风险因素仅解释所有病例的10-20%。很少有研究调查母亲在怀孕期间的身体暴露及其后代患CCM的风险。本研究采用病例对照研究设计，从1988年1月至1991年6月出生于纽约州14个县的母亲的所有活产婴儿中抽取502例病例和1066例对照，研究妊娠早期暴露于极端温度、长时间站立和举重与后代CCM风险之间的关系。病例是从基于人群的先天性畸形登记中确定的。对照组是从出生证明记录中随机选择的。访谈通过电话进行，使用结构化问卷。接触估计数是根据妇女对住所和工作场所条件的自我报告得出的。83%的母亲是白色人，66%的母亲年龄在25 - 34岁之间。在调整了所有已知的危险因素和混杂变量后，我们发现母亲在怀孕早期暴露于极热环境中的受试者患CCM的风险没有显著增加（OR = 1.13，95% CI 0.59，2.19），与极寒无关（OR = 1.19，95% CI 0.66，2.15）。报告在妊娠早期使用热水浴缸、热水浴或桑拿浴的母亲，其后代患CCM的风险没有增加（OR = 0.88，95%CI 0.65，1.18）。在妊娠早期进行举重并没有增加后代患CCM的风险（OR = 0.80，95%CI 0.57，1.11）。妊娠早期长时间站立与儿童CCM风险增加无关（OR = 1.03，95%CI 0.82，1.28）。因此，如果这些母体接触产生不良影响，则不太可能涉及CCM。
Congenital cardiovascular malformations (CCM) cause substantial neonatal morbidity and mortality. Known risk factors for CCM explain only 10-20% of all cases. Few studies have examined mothers' physical exposures during pregnancy and the risk of CCM in their offspring. This study examined the association between exposures to extreme temperatures, prolonged standing, and heavy lifting during early pregnancy and risk of CCM in offspring.Using a case-control study design, 502 cases and 1066 controls were drawn from the population of all liveborn infants born between January 1988 and June 1991 to mothers living in 14 counties in New York State. Cases were identified from a population-based registry of congenital malformations. Controls were randomly selected from birth certificate records. Interviews were conducted by telephone, using a structured questionnaire. Exposure estimates were based on women's self-reports of conditions in the residence and workplace. Eighty-three per cent of the mothers were white, and 66% were between 25 and 34 years old.After adjusting all results for known risk factors and confounding variables, we found no significant increased risk of CCM in subjects whose mothers reported being exposed during early pregnancy to extreme heat (OR = 1.13, 95% CI 0.59, 2.19), nor to extreme cold (OR = 1.19, 95% CI 0.66, 2.15). Mothers who reported ever using a hot tub, hot bath, or sauna during early pregnancy had no increased risk of CCM in their offspring (OR = 0.88, 95% CI 0.65, 1.18). Performing heavy lifting during early pregnancy did not increase the risk of CCM in offspring (OR = 0.80, 95% CI 0.57, 1.11). Prolonged standing during early pregnancy was not associated with an increased risk of CCM in children (OR = 1.03, 95% CI 0.82, 1.28). Thus if these maternal exposures have an adverse effect, it is unlikely to involve CCMs.