Maternal autoimmune disease and birth defects in the National Birth Defects Prevention Study.
Maternal autoimmune disease and birth defects in the National Birth Defects Prevention Study.
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DOI：
10.1002/bdra.23527
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发表时间：
2016-11
期刊：
影响因子：
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通讯作者：
National Birth Defects Prevention Study
中科院分区：
文献类型：
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作者：
Howley MM;Browne ML;Van Zutphen AR;Richardson SD;Blossom SJ;Broussard CS;Carmichael SL;Druschel CM;National Birth Defects Prevention Study
关于母体自身免疫性疾病或其治疗与出生缺陷风险之间的关系知之甚少。我们使用来自国家出生缺陷预防研究的数据检查了这些关联，该研究是一项多地点，基于人群的病例对照研究。分析包括25,116例病例和9897例未受影响的对照婴儿，估计分娩日期在1997年至2009年之间。通过电话访谈收集自身免疫性疾病、药物使用和其他妊娠暴露的信息。估计了5例或5例以上暴露病例的出生缺陷的校正比值比（OR）和95%置信区间（CI）;估计了3 - 4例暴露病例的出生缺陷的粗OR和精确95% CI。373名母亲报告了自身免疫性疾病（279例病例和94例对照母亲）。评价的大多数出生缺陷与自身免疫性疾病无关;然而，观察到母体自身免疫性疾病与脑膨出之间存在统计学显著相关性（OR，4.64; 95% CI，1.95-11.04）。82名患有自身免疫性疾病的母亲在怀孕期间使用免疫调节/抑制药物;这与脑膨出（OR，7.26; 95%CI，1.37-24.61）和房间隔缺损（OR，3.01; 95%CI，1.16-7.80）相关。我们的研究结果表明，母体自身免疫性疾病和治疗与大多数出生缺陷无关，但可能与某些缺陷有关，特别是脑膨出。由于个体自身免疫性疾病的发病率较低，并且很少使用特定的药物，我们无法检查特定自身免疫性疾病和药物与出生缺陷的相关性。需要其他研究来证实这些发现。
Little is known about the association between maternal autoimmune disease or its treatment and the risk of birth defects. We examined these associations using data from the National Birth Defects Prevention Study, a multi-site, population-based, case–control study. Analyses included 25,116 case and 9897 unaffected control infants with estimated delivery dates between 1997 and 2009. Information on autoimmune disease, medication use, and other pregnancy exposures was collected by means of telephone interview. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for birth defects with five or more exposed cases; crude ORs and exact 95% CIs were estimated for birth defects with three to four exposed cases. Autoimmune disease was reported by 373 mothers (279 case and 94 control mothers). The majority of birth defects evaluated were not associated with autoimmune disease; however, a statistically significant association between maternal autoimmune disease and encephalocele was observed (OR, 4.64; 95% CI, 1.95–11.04). Eighty-two mothers with autoimmune disease used an immune modifying/suppressing medication during pregnancy; this was associated with encephalocele (OR, 7.26; 95% CI, 1.37–24.61) and atrial septal defects (OR, 3.01; 95% CI, 1.16–7.80). Our findings suggest maternal autoimmune disease and treatment are not associated with the majority of birth defects, but may be associated with some defects, particularly encephalocele. Given the low prevalence of individual autoimmune diseases and the rare use of specific medications, we were unable to examine associations of specific autoimmune diseases and medications with birth defects. Other studies are needed to confirm these findings.