Vasoactive exposures and risk of amniotic band syndrome and terminal transverse limb deficiencies.
Vasoactive exposures and risk of amniotic band syndrome and terminal transverse limb deficiencies.
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DOI：
10.1002/bdr2.1740
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发表时间：
2020-08
影响因子：
2.1
通讯作者：
Werler, Martha M.
中科院分区：
文献类型：
--
作者：
Adrien, Nedghie;Petersen, Julie M.;Parker, Samantha E.;Werler, Martha M.
关键词：
羊膜带综合征（ABS）包括肢体缺陷，伴有起源于羊膜衬里的纤维束。终末横肢缺陷（TTLD）似乎是相似的，但缺乏纤维束。两者都被假设为血管破裂所致。对于ABS，肢体缺陷被认为是继发于羊膜破裂。我们探讨了另一种可能性，即TTLD是主要缺陷，ABS是次要缺陷。利用国家出生缺陷预防研究的数据，我们扩展了以前的研究。我们检查了吸烟、饮酒和药物，根据血管活性分类作为血管破裂的标志物。使用Firth惩罚似然的Logistic回归模型估计调整后的比值比（aOR）和95%置信区间（CI）。使用支气管扩张剂和阿司匹林似乎增加了ABS的风险，而减充血剂和非阿司匹林NSAID增加了TTLD的风险。在报告血管活性药物暴露组合的病例中，ABS风险显著增加，特别是酒精和阿司匹林（aOR 3.7，95% CI 1.6，7.8）以及酒精和支气管扩张剂（aOR 3.4，95% CI 1.4，7.5）。仅在吸烟和减充血剂中观察到血管活性暴露联合导致TTLD风险增加（aOR 2.3，95% CI 1.4，3.6）。与ABS风险增加相关的暴露与TTLD无明显相关性，支持先前的证据表明这些可能是不同的表型。ABS似乎与具有血管舒张特性的组合暴露（如酒精和支气管扩张剂）相关，而TTLD风险增加可能与吸烟和减充血剂（均为血管收缩暴露）相关。
Amniotic band syndrome (ABS) includes limb deficiencies accompanied by fibrous strands originating from the amniotic lining. Terminal transverse limb deficiencies (TTLD) appear to be similar but lack fibrous strands. Both are hypothesized to result from vascular disruption. For ABS, limb deficiencies are considered secondary to amnion rupture. We explored an alternative possibility—that TTLD is the primary defect and ABS is secondary. Using data from the National Birth Defects Prevention Study, we expanded on a previous study. We examined smoking, alcohol, and medications categorized by indicated vasoactivity as markers of vascular disruption. Logistic regression models with Firth's penalized likelihood were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Use of bronchodilators and aspirin appeared to increase the risk of ABS, while decongestants and nonaspirin NSAIDs increased the risk of TTLD. The risk of ABS was markedly increased in cases reporting combinations of vasoactive exposures, particularly alcohol and aspirin (aOR 3.7, 95% CI 1.6, 7.8), and alcohol and bronchodilators (aOR 3.4, 95% CI 1.4, 7.5). Increased risk of TTLD due to combinations of vasoactive exposures was only observed for smoking and decongestants (aOR 2.3, 95% CI 1.4, 3.6). Exposures associated with increased risk of ABS had no apparent association with TTLD, supporting previous evidence that these may be distinct phenotypes. ABS appears to be associated with combined exposures with vasodilation properties, such as alcohol and bronchodilators, while increased risk of TTLD may be associated with smoking and decongestants, both vasoconstrictive exposures.
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DOI：
10.1001/archpedi.1988.02150050079037
发表时间：
1988-05-01
影响因子：
--
作者：
GARZA, A;CORDERO, JF;MULINARE, J
通讯作者：
MULINARE, J
影响因子：
7.7
作者：
DREWS, CD;KRAUS, JF;GREENLAND, S
通讯作者：
GREENLAND, S
影响因子：
7.7
作者：
ARO, T;HAAPAKOSKI, J;HEINONEN, OP
通讯作者：
HEINONEN, OP
DOI：
10.1002/bdra.20238
发表时间：
2006-03-01
影响因子：
--
作者：
Lam, PK;Torfs, CP
通讯作者：
Torfs, CP
影响因子：
13.6
作者：
Andersson, T;Alfredsson, L;Ahlbom, A
通讯作者：
Ahlbom, A