Maternal fever, multivitamin use, and selected birth defects: Evidence of interaction?
Maternal fever, multivitamin use, and selected birth defects: Evidence of interaction?
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DOI：
10.1097/00001648-200207000-00019
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发表时间：
2002-07-01
期刊：
影响因子：
5.4
通讯作者：
Liu, YC
中科院分区：
文献类型：
--
作者：
Botto, LD;Erickson, JD;Liu, YC
背景多种维生素的使用与某些出生缺陷的风险降低有关。我们评估是否使用多种维生素改变出生缺陷风险与发热性疾病，一种常见的和可能的致畸性疾病。从基于人群的亚特兰大出生缺陷病例对照研究（1968-1980）中，我们选择了7种缺陷（神经管缺陷、唇腭裂、心脏流出道缺陷、室间隔缺陷、心房缺陷、脐膨出和肢体缺陷），因为它们与先前分析中记录的多种维生素补充剂的使用呈反比关系。我们定义了四种暴露类别，包括复合维生素使用（围产期使用与未使用相比）和发热性疾病（早孕与未患病相比）。参考类别是没有使用多种维生素和没有疾病。未使用复合维生素的发热性疾病与7种缺陷和联合组的风险普遍增加相关（比值比分别为2.1、1.7、1.5、1.9、2.9、4.4、3.3和2.3）。然而，使用复合维生素，与发热性疾病相关的风险估计通常较低（比值比分别为0.6，1.1，0.0，1.5，0.0，0.8，0.0和0.8）。一些相关的95%置信区间包括1。结论。研究结果表明，多种维生素的使用可能会降低与发热性疾病相关的风险。
Background. Multivitamin use has been associated with lower risks for some birth defects. We evaluated whether multivitamin use modified birth defect risks associated with febrile illness, a common and possibly teratogenic exposure.Methods. From the population-based Atlanta Birth Defects Case-Control Study (1968-1980) we selected seven defects (neural tube defects, cleft lip and palate, cardiac outflow tract defects, ventricular septal defects, atrial defects, omphalocele, and limb deficiencies) because of their inverse relation with multivitamin supplement use documented in previous analyses. We defined four exposure categories form combinations of multivitamin use (periceptional use compared with no use) and febrile illness( early pregnancy compared with no illness). The reference category was no multivitamin use and no illness.Results. Febrile illness with no multivitamin use was associated with generally increased risk for the seven defects and the combined group (odds ratio = 2.1, 1.7, 1.5, 1.9, 2.9, 4.4, 3.3, and 2.3, respectively). With multivitamin use, however, the risk estimates associated with febrile illness were generally lower (odds ratio = 0.6, 1.1, 0.0, 1.5, 0.0, 0.8, 0.0, and 0.8, respectively). Some of the associated 95% confidence intervals included one.Conclusions. The pattern of findings suggest that multivitamin use might decrease the risk associated with febrile illness.