Socio-economic status and risk of conotruncal heart defects and orofacial clefts
Socio-economic status and risk of conotruncal heart defects and orofacial clefts
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DOI：
10.1046/j.1365-3016.2003.00498.x
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发表时间：
2003-07-01
影响因子：
2.8
通讯作者：
Croen, LA
中科院分区：
文献类型：
--
作者：
Carmichael, SL;Nelson, V;Croen, LA
社会经济地位（SES）的研究在与各种健康结果相关的研究中占有突出地位，尽管SES是否有助于先天性异常的病因学仍然存在问题。本研究探讨SES与圆锥动脉干心脏缺陷和口面裂的风险之间的关系，使用来自696例病例母亲（86%的合格）和734例（78%）对照母亲的访谈数据，这些母亲来自一项基于人群的病例对照研究。母亲访谈的社会经济指标包括母亲的教育和就业。报告的地址与美国人口普查联系在一起，以衡量社区的社会经济地位（教育，贫困，失业，职业，拥挤和出租）。结果调整种族，多种维生素/矿物质补充剂的摄入量，吸烟和暴饮暴食，个人和邻里措施的结果表明，低SES与大动脉转位（dTGA）的风险增加，降低法洛四联症（TOF）的风险，但与口面裂的风险无关。例如，当检查比值比（OR）时，比较了居住在基于人口普查的SES指标的最低和最高四分位数的妇女的风险时，六项指标中有五项的OR对于dTGA> 1.4，所有六项指标的OR对于TOR < 0.7，对于裂缝的OR往往接近1。这项研究表明，SES风险是出生缺陷特异性的。
Studies of socio-economic status (SES) have figured prominently in research related to a variety of health outcomes, although the question remains as to whether SES contributes to the aetiologies of congenital anomalies. This study examines the association of SES with risks of conotruncal heart defects and orofacial clefts, using interview data from 696 case mothers (86% of eligible) and 734 (78%) control mothers from a population-based case-control study. Socio-economic measures from maternal interview included mother's education and employment. Reported addresses were linked with the US census to characterise six measures of neighbourhood SES (education, poverty, unemployment, occupation, crowding and rental occupancy). Results were adjusted for race-ethnicity, multivitamin/mineral supplement intake, cigarette smoking and binge drinking.Results for individual and neighbourhood measures suggested that low SES was associated with increased risk of d-transposition of the great arteries (dTGA), reduced risk of tetralogy of Fallot (TOF), but was not associated with risk of orofacial clefts. For example, when examining odds ratios (OR) that compared risks among women whose neighbourhoods were in the lowest vs. highest quartile of the census-based SES measures, ORs for five of the six measures were > 1.4 for dTGA, and ORs for all six measures were < 0.7 for TOR ORs for clefts tended to be closer to 1. This study suggests that SES risks are birth defect specific.