Maternal Chlamydia Infection During Pregnancy and Risk of Cyanotic Congenital Heart Defects in the Offspring
Maternal Chlamydia Infection During Pregnancy and Risk of Cyanotic Congenital Heart Defects in the Offspring
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DOI：
10.1007/s10995-015-1804-0
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发表时间：
2016-01-01
影响因子：
2.3
通讯作者：
Kancherla, Vijaya
中科院分区：
文献类型：
--
作者：
Dong, Diane Y.;Binongo, Jose N.;Kancherla, Vijaya
目的生殖器衣原体是育龄妇女，尤其是青壮年妇女中常见的细菌性性传播感染。青紫型先天性心脏病(CCHD)约占出生时心脏畸形的四分之一，发病率和死亡率较高。对孕期母体衣原体感染与子代衣原体感染关系的流行病学研究较少。方法利用2012年美国出生证明资料，对单胎活产儿(2487例)和未感染单胎新生儿(3334,424例)进行产前衣原体感染与衣原体感染的相关性研究。我们使用非条件Logistic回归分析估计了所有合并的CCHD和单独的CCHD(没有其他主要先天性畸形)的调整优势比(AORS)和95%可信区间(CI)。结果总的来说，1.7%的病例和1.7%的对照妇女报告在怀孕期间有衣原体感染。在控制了潜在的混杂因素后，我们发现孕期母亲衣原体感染与所有CCHD合并的相关性较弱(AOR=1.39；95%CI 1.02-1.90)。在单独的CCHD病例中，阳性关联持续存在，但有边缘意义(AOR=1.34；95%CI为0.96~1.74)。对年轻女性的亚组分析显示，患CCHD的风险增加；然而，这种关联没有统计学意义。结论母亲孕期暴露于衣原体与子代患CCHD的风险较高有微弱关联。由于出生证明数据的限制，对这一发现的解读应该谨慎。未来的研究需要使用更可靠的数据来源，以进一步研究孕期母体衣原体感染与子代CCHD之间的关联。
Objectives Genital Chlamydia is a common bacterial sexually-transmitted infection among reproductive aged women, particularly younger populations. Cyanotic congenital heart defects (CCHDs) constitute about one quarter of all cardiac malformations at birth, and are associated with high rate of morbidity and mortality. Epidemiological research on the association between maternal Chlamydia during pregnancy and CCHDs in the offspring is lacking.Methods Using data from the 2012 United States birth certificates, we examined the association between CCHDs and prenatal exposure to Chlamydia among live singleton births with CCHDs (n = 2487) and unaffected singleton births (n = 3,334,424). We estimated adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) using unconditional logistic regression analysis for all CCHDs combined, and isolated CCHDs (without other major congenital malformations).Results Overall 1.7 % of case and 1.7 % of control women reported having Chlamydia during their pregnancies. After controlling for potential confounders, we found a weak positive association between maternal Chlamydia during pregnancy and all CCHDs combined (aOR = 1.39; 95 % CI 1.02-1.90). The positive association persisted for isolated CCHD cases, but with marginal significance (aOR = 1.34; 95 % CI 0.96-1.74). Subgroup analyses for younger women showed an increased risk for CCHDs; however, the associations were not statistically significant.Conclusions Maternal exposure to Chlamydia during pregnancy was weakly associated with a higher risk of CCHDs in the offspring. The finding should be interpreted with caution due to limitations of birth certificate data. Future studies using more robust data sources are warranted to further study the association between maternal Chlamydia during pregnancy and CCHDs in the offspring.