Congenital Malformations in the Newborn Population: A Population Study and Analysis of the Effect of Sex and Prematurity
Congenital Malformations in the Newborn Population: A Population Study and Analysis of the Effect of Sex and Prematurity
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DOI：
10.1016/j.pedneo.2014.03.010
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发表时间：
2015-02-01
影响因子：
2.1
通讯作者：
Srivastava, Shubhika
中科院分区：
文献类型：
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作者：
Egbe, Alexander;Uppu, Santosh;Srivastava, Shubhika
背景：先天性畸形（CM）是婴儿死亡的主要原因。我们假设，目前的估计CM的患病率是过时的，因为终止胎儿与严重CMs和产前vitamin.Methods的广泛使用率的增加：这种以人群为基础的横断面研究分析了性别和早产对CM患病率的影响。所有数据均来自2008年全国住院患者样本（NIS）数据库中的出生条目。我们的目标是确定在2008年所有出生住院CM诊断的患病率，并分析性别和妊娠成熟度对CM prevalence.Results的影响：我们确定了29,312例CM患者中的1,014,261活产，这产生了CM患病率为28.9每1000活产。1172例（4%）患者存在相关遗传综合征。在非综合征型CM的新生儿中，91%的新生儿有孤立的CM，9%的新生儿有多个CM。心血管系统是最常见的受累器官系统。早产新生儿中发生孤立性CM [比值比（OR），1.5;置信区间（CI），1.4-1.5]、多个CM（OR，2.1; CI，2.0-2.3）和总体CM（OR，1.4; CI，1.3-1.5）的风险显著较高。男性孤立性CM的风险较高（OR，1.3; CI，1.2-1.5）。然而，没有性别差异的风险整体CM。结论：我们报告了最新的国家估计的患病率CM，这是非常重要的监测趋势，确定服务规划，并评估疾病负担，因为在美国的先天性畸形。我们还显示了CM和早产之间的强关联。需要进一步研究这种关联，以深入了解这些相对常见的公共卫生问题的病因。版权所有（C）2014，台湾儿科医学会.出版社：Elsevier Taiwan LLC All rights reserved.
Background: Congenital malformation (CM) is a leading cause of infant mortality. We hypothesized that the current estimates of the prevalence of CM are obsolete because of the increased rate of terminating fetuses with severe CMs and the widespread use of prenatal vitamins.Methods: This population-based cross-sectional study analyzed the effect of sex and prematurity on CM prevalence. All data were derived from birth entries in the 2008 Nationwide Inpatient Sample (NIS) database. Our objectives were to determine the prevalence of CM diagnoses among all birth hospitalizations in 2008 and to analyze the effect of sex and gestational maturity on CM prevalence.Results: We identified 29,312 patients with CMs from among 1,014,261 live births, which yielded a CM prevalence of 28.9 per 1000 live births. Associated genetic syndromes were present in 1172 (4%) patients. Among newborns with nonsyndromic CM, 91% of newborns had an isolated CM and 9% of newborns had multiple CMs. The cardiovascular system was the most commonly involved organ system. The risk of CM was significantly higher in preterm newborns for an isolated CM [odds ratio (OR), 1.5; confidence interval (CI), 1.4-1.5]; multiple CMs (OR, 2.1; CI, 2.0-2.3); and overall CMs (OR, 1.4; CI, 1.3-1.5). Males had higher risk of isolated CMs (OR, 1.3; CI, 1.2-1.5). However, there was no sex difference in the risk of overall CM.Conclusion: We reported up-to-date national estimates of the prevalence of CM, which is important for monitoring trends, determining service planning, and assessing disease burden because of congenital malformations in the United States of America. We also showed a strong association between CM and prematurity. Further study of this association is needed to provide insight into the etiology of these relatively common public health problems. Copyright (C) 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.