Defective Placentation Syndromes and Intellectual Disability in the Offspring: Nationwide Cohort and Sibling-Controlled Studies.
Defective Placentation Syndromes and Intellectual Disability in the Offspring: Nationwide Cohort and Sibling-Controlled Studies.
复制标题
后代胎盘缺陷综合征和智力障碍：全国队列和兄弟姐妹对照研究。
DOI：
10.1093/aje/kwac068
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发表时间：
2022
影响因子：
5
通讯作者：
Cnattingius,Sven
中科院分区：
文献类型：
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作者：
Villamor,Eduardo;Susser,EzraS;Cnattingius,Sven
我们通过对1998年至2014年期间在瑞典出生的1，581，200名无畸形的活单胎婴儿进行基于人群的队列研究，调查了胎盘缺陷综合征表现与后代智力残疾（ID）发生率之间的关系。暴露为：1）胎盘早剥，2）早产先兆子痫（<34周妊娠），3）先兆子痫合并婴儿出生时小于胎龄（SGA），和4）自发性早产。结果是3岁后的ID诊断。我们使用考克斯回归和稳健方差估计每种综合征的风险比（HR）和95%置信区间（CI）。有9，451名儿童患有ID（每10，000儿童年5.5人）。ID发病率随胎盘排斥的增加而增加（HR = 2.8，95% CI：2.3，3.5），早产先兆子痫（HR = 3.7，95% CI：2.9，4.7），先兆子痫合并SGA（HR = 3.3，95% CI：2.6，4.1）和自发性早产（32-36周和22-31周，HR分别为1.6（95% CI：1.4，1.8）和5.2（95% CI：4.3，6.2））。在对1，043，158名同胞进行的同胞对照分析中，同样的结果模式也很明显。关联的强度随着ID严重程度的增加而增加。早产只能部分解释胎盘功能不全、子痫前期或SGA与ID的关系。我们得出结论，胎盘功能不全与后代ID发病率增加有关。
We investigated the relationships between syndromic manifestations of defective placentation and the incidence of intellectual disability (ID) in offspring by conducting a population-based cohort study of 1,581,200 nonmalformed, live singleton infants born in Sweden between 1998 and 2014. Exposures were: 1) placental abruption, 2) preterm preeclampsia (<34 weeks of gestation), 3) preeclampsia combined with infant being small for gestational age (SGA) at birth, and 4) spontaneous preterm birth. The outcome was an ID diagnosis after 3 years of age. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for each syndrome using Cox regression and robust variances. There were 9,451 children with ID (5.5 per 10,000 child-years). ID incidence rates increased with placental abruption (HR = 2.8, 95% CI: 2.3, 3.5), preterm preeclampsia (HR = 3.7, 95% CI: 2.9, 4.7), preeclampsia combined with SGA (HR = 3.3, 95% CI: 2.6, 4.1), and spontaneous preterm birth (for 32–36 and 22–31 weeks, respectively, HR = 1.6 (95% CI: 1.4, 1.8) and 5.2 (95% CI: 4.3, 6.2)). The same pattern of results was evident in sibling-controlled analyses among 1,043,158 full siblings. The strength of associations increased with ID severity. Preterm birth only partly explained the associations of placental abruption, preeclampsia, or SGA with ID. We conclude that defective placentation is related to increased incidence of ID in the offspring.