Epidemiology of noncomplex left ventricular outflow tract obstruction malformations (aortic valve stenosis, coarctation of the aorta, hypoplastic left heart syndrome) in Texas, 1999-2001
Epidemiology of noncomplex left ventricular outflow tract obstruction malformations (aortic valve stenosis, coarctation of the aorta, hypoplastic left heart syndrome) in Texas, 1999-2001
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DOI：
10.1002/bdra.20169
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发表时间：
2005-08-01
影响因子：
--
通讯作者：
Belmont, JW
中科院分区：
文献类型：
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作者：
McBride, KL;Marengo, L;Belmont, JW
背景技术背景：左心室流出道（LVOT）畸形、主动脉瓣狭窄（AVS）、主动脉缩窄（CoA）和左心发育不良综合征（HLHS）是出生缺陷导致婴儿死亡的重要原因。以前的流行病学数据显示，男性和女性以及白色和黑色种族群体之间的比率存在差异。德克萨斯州出生缺陷登记处是一个积极的监测项目，可以在包括西班牙裔在内的大量不同人群中进行研究。方法：从登记处收集1999年至2001年在德克萨斯州出生的1岁以下患有AVS、CoA和HLHS的儿童的记录。包括额外的心脏缺陷或染色体异常的患者被排除在外。多变量分析包括：婴儿性别;美国-墨西哥边境县居住地;和产妇年龄，种族/民族，出生地和教育。结果：在108万例活产婴儿中有910例病例，其中499例符合纳入标准。所有LVOT畸形的多变量建模显示黑人男性（0.26）和西班牙裔男性（0.70）的患病率比（PRR）较低。CoA的结果相似，但AVS或HLHS的结果不同。LVOT（24-34岁为1.3;> 34岁为1.7）、AVS和HLHS（但非CoA）的母亲年龄增加时PRR较高，所有诊断中男性的PRR较高（LVOT PRR，2.4）。边境县居民的CoA PRR高于非边境县居民（PRR，2.1）。母亲文化程度和出生地不是显著影响因素。结论：所有3个种族群体中男性的比率存在差异。性别和种族差异提示遗传病因学，其中种族差异可用于通过混合连锁不平衡作图来寻找易感基因座。沿着美国-墨西哥边境表明，环境原因，将需要进一步监测。(c)2005 Wiley-Liss，Inc.
BACKGROUND: The left ventricular outflow tract (LVOT) malformations aortic valve stenosis (AVS), coarctation of the aorta (CoA), and hypoplastic left heart syndrome (HLHS) contribute significantly to infant mortality due to birth defects. Previous epidemiology data showed rate differences between male and female and white and black ethnic groups. The Texas Birth Defects Registry, an active surveillance program, enables study in a large, diverse population including Hispanics. METHODS: Records of children up to I year old with AVS, CoA, and HLHS born in Texas from 1999 to 2001, were collected from the registry. Those including additional heart defects or a chromosomal anomaly were excluded. Multivariate analysis included: infant sex; United States-Mexico border county residence; and maternal age, race/ethnicity, birthplace, and education. RESULTS: There were 910 cases among 1.08 million live births, of which 499 met inclusion criteria. Multivariate modeling of all LVOT malformations combined demonstrated lower prevalence rate ratios (PRRs) for black males (0.26) and Hispanic males (0.70). Similar results were found for CoA but not AVS or HLHS. Higher PRRs were noted for increased maternal age for LVOT (1.3 for 24-34 years; 1.7 for > 34 years), AVS, and HLHS, but not CoA, and higher PRRs across all diagnoses for males (LVOT PRR, 2.4) were noted. CoA PRRs were higher in border county vs. non-border county residents (PRR, 2.1). Maternal education and birthplace were not significant factors. CONCLUSIONS: There are rate differences for males among all 3 ethnic groups. Sex and ethnic differences suggest genetic etiologies, where the ethnic differences could be used to find susceptibility loci with mapping by admixture linkage disequilibrium. Increased CoA rates along the U.S.-Mexico border suggest environmental causes that will require further monitoring.(c) 2005 Wiley-Liss, Inc.