Association of maternal diseases during pregnancy with the risk of single ventricular septal defects in the offspring - a population-based case-control study
Association of maternal diseases during pregnancy with the risk of single ventricular septal defects in the offspring - a population-based case-control study
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DOI：
10.3109/14767058.2012.755170
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发表时间：
2013-05-01
影响因子：
1.8
通讯作者：
Czeizel, Andrew E.
中科院分区：
文献类型：
--
作者：
Csaky-Szunyogh, Melinda;Vereczkey, Attila;Czeizel, Andrew E.
目的：一般来说，分析流行病学研究对先天性心脏缺陷（CHD）病例进行了评估。然而，不同的先心病实体有不同的病因，并且绝大多数患者的根本原因尚不清楚。因此，本研究的目的是评估手术干预后单室间隔缺损 (VSD) 起源或致死结果的可能病因，即尽可能同质。 方法：在匈牙利先天性异常病例对照监测的基于人群的大数据集中，对 1661 例孤立/单室 VSD 病例的母亲进行了急性和慢性孕产妇疾病以及相关药物治疗和孕早期妊娠补充剂的评估，并评估了这些疾病的发生情况。 2 534 例匹配，38 151 例无缺陷对照，19 833 例畸形对照伴有其他孤立的非心脏缺陷。结果：在 VSD 关键期，高烧相关流感母亲的孩子发生 VSD 的风险较高，并且通过退烧治疗可以限制这种风险。此外，使用抗惊厥药物治疗的阵发性室上性心动过速和癫痫与较高的 VSD 风险相关。最后，妊娠早期单独服用高剂量叶酸。结论：高烧相关的母体疾病可能在VSD的起源中发挥作用，通过退烧药物治疗可以预防VSD，并且妊娠早期高剂量叶酸降低了VSD的风险。
Objective: In general, the analytical epidemiological studies evaluated cases with congenital heart defects (CHDs) together. However, different CHD entities have different etiology, and in the vast majority of patients the underlying causes are unclear. Thus the objective of the study was to evaluate the possible etiological factors in the origin of single ventricular septal defect (VSD) after surgical intervention or lethal outcome, i.e. as homogeneous as possible.Method: In the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities acute and chronic maternal diseases with related drug treatments and pregnancy supplements in early pregnancy were evaluated in the mothers of 1661 cases with isolated/single VSD and their 2534 matched and 38 151 all controls without defect, and 19 833 malformed controls with other isolated non-cardiac defect.Results: There was a higher risk of VSD in the children of mothers with high fever related influenza during the critical period of VSD and this risk was limited by antifever therapy. In addition paroxysmal supraventricular tachycardia and epilepsy treated with anticonvulsant drugs associated with higher risk of VSD. Finally, the high doses of folic acid alone in early pregnancy.Conclusions: High-fever-related maternal diseases may have a role in the origin of VSD which is preventable with antifever drug therapy, and the high doses of folic acid in early pregnancy reduced the risk of VSD.