Maternal urinary tract infections and selected cardiovascular malformations
Maternal urinary tract infections and selected cardiovascular malformations
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DOI：
10.1002/bdra.20460
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发表时间：
2008-06-01
影响因子：
--
通讯作者：
Hobbs, Charlotte A.
中科院分区：
文献类型：
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作者：
Cleves, Mario A.;Malik, Sadia;Hobbs, Charlotte A.
背景：在一项基于人群的病例对照研究中，我们调查了先天性心血管畸形（cvm）与产妇尿路感染（uti）之间的关系。方法：在国家出生缺陷预防研究中，确定了3,690名患有非综合征性cvm的单胎妇女和4,760名无出生缺陷婴儿的妇女。受影响的婴儿有：圆锥截骨，室间隔，肺静脉回流异常，房室间隔缺损，或左侧或右侧梗阻性心脏缺损。如果母亲在妊娠早期报告至少有一次感染，那么她们就有尿路感染。计算调整后的or和95% ci来确定cvm和uti之间的关联。进行分层分析以调查磺胺使用和/或发热是否会改变cvm和uti之间的效果。结果：有左心室流出道梗阻性缺陷或房室间隔缺陷的后代的妇女比对照组更容易报告尿路感染。这些关联在没有发烧或使用磺胺类药物的妇女中仍然存在。产妇在尿路感染期间使用磺胺类药物似乎没有改变CVM亚型与产妇尿路感染之间的关系。结论：在国家出生缺陷预防研究中，几乎没有证据支持妊娠前三个月cvm和uti之间的关联。发现左心室流出道梗阻性缺陷与母体尿路感染之间以及房室间隔缺陷与母体尿路感染之间存在关联。我们的研究结果虽然不是结论性的，但表明母体UTI与cvm之间可能存在的关联应该进一步研究。
BACKGROUND: In a population-based case-control study, we investigated the association between congenital cardiovascular malformations (CVMs) and maternal urinary tract infections (UTIs). METHODS: Within the National Birth Defects Prevention Study, 3,690 women who had singleton livebirths with nonsyndromic CVMs, and 4,760 women who had infants without birth defects were identified. Affected infants had: conotruncal, septal, anomalous pulmonary venous return, atrioventricular septal defects, or left- or right-sided obstructive heart defects. Mothers had a UTI if they reported having at least one infection during the first trimester. Adjusted ORs and 95% CIs were computed to determine the association between CVMs and UTIs. Stratified analyses were conducted to investigate if sulfonamide use and/or fever modified the effect between CVMs and UTIs. RESULTS: Women who had offspring with either left ventricular outflow tract obstructive defects or atrioventricular septal defects were more likely than controls to report a UTI. These associations remained among women who did not have fever or used sulfonamides. Maternal use of sulfonamides during the UTI did not appear to modify the relationship between CVM subtypes and maternal UTIs. CONCLUSIONS: In the National Birth Defects Prevention Study there was little evidence to support an association between CVMs and UTIs during the first trimester of pregnancy. Associations between left ventricular outflow tract obstructive defects and maternal UTI as well as between atrioventricular septal defects and maternal UTI were found. Our findings, while not conclusive, suggest that the possible association between maternal UTI and CVMs should be investigated further.