Prevalence and Risk of Birth Defects Observed in a Prospective Cohort Study: The Hokkaido Study on Environment and Children's Health.
Prevalence and Risk of Birth Defects Observed in a Prospective Cohort Study: The Hokkaido Study on Environment and Children's Health.
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DOI：
10.2188/jea.je20160108
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发表时间：
2018-03-05
影响因子：
4.7
通讯作者：
other members of the Hokkaido Study on Environment and Children’s Health
中科院分区：
文献类型：
--
作者：
Hanaoka T;Tamura N;Ito K;Sasaki S;Araki A;Ikeno T;Miyashita C;Ito S;Minakami H;Cho K;Endo T;Baba T;Miyamoto T;Sengoku K;Kishi R;other members of the Hokkaido Study on Environment and Children’s Health
所有被归类为出生缺陷的异常（包括妊娠 22 周之前发现的异常）的患病率在已发表的报告（包括国际出生缺陷监测和研究信息交换所 (ICBDSR) 的报告）中受到限制。在我们的出生队列研究中，我们收集了妊娠 12 周后所有出生缺陷的数据。这项研究的对象包括 19,244 名孕妇，她们于 2003 年至 2012 年间到北海道县 37 家相关医院之一就诊，并完成了随访。妊娠 12 周后的所有出生缺陷，包括 55 种与环境化学暴露相关的标记异常，均被记录。我们研究了父母出生缺陷的危险因素以及出生缺陷与生长迟缓风险之间的关联。所有出生缺陷的患病率为 18.9/1,000 名新生儿。妊娠 12 至 21 周期间分娩的出生缺陷患者比例约为所有出生缺陷患者的十分之一。在患有先天性神经系统畸形的患者中，39%是在妊娠 22 周之前分娩的。所有无脑畸形和脑膨出患者均在妊娠 22 周前分娩。我们观察到 ISBDSR 中包含的出生缺陷病例和未包含在内的出生缺陷病例之间父母危险因素的不同模式。 ISBDSR 中包含的病例与早产风险增加相关。未纳入 ISBDSR 的病例与足月小于胎龄的风险增加相关。我们的研究数据补充了 ICBDSR 的数据。我们建议也对 ICBDSR 中未包含的出生缺陷进行分析，以阐明出生缺陷的病因。
Prevalence rates of all anomalies classified as birth defects, including those identified before the 22nd gestational week, are limited in published reports, including those from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). In our birth cohort study, we collected the data for all birth defects after 12 weeks of gestation. Subjects in this study comprised 19,244 pregnant women who visited one of 37 associated hospitals in the Hokkaido Prefecture from 2003 through 2012, and completed follow-up. All birth defects after 12 weeks of gestation, including 55 marker anomalies associated with environmental chemical exposures, were recorded. We examined parental risk factors for birth defects and the association between birth defects and risk of growth retardation. Prevalence of all birth defects was 18.9/1,000 births. The proportion of patients with birth defects delivered between 12 and 21 weeks of gestation was approximately one-tenth of all patients with birth defects. Among those with congenital malformation of the nerve system, 39% were delivered before 22 weeks of gestation. All patients with anencephaly and encephalocele were delivered before 22 weeks of gestation. We observed different patterns of parental risk factors between birth defect cases included in ISBDSR and cases not included. Cases included in ISBDSR were associated with an increased risk of preterm birth. Cases not included in ISBDSR were associated with an increased risk of being small for gestational age at term. Data from our study complemented the data from ICBDSR. We recommend that birth defects not included in ICBDSR also be analyzed to elucidate the etiology of birth defects.