Maternal overweight and obesity and risk of congenital heart defects in offspring.
Maternal overweight and obesity and risk of congenital heart defects in offspring.
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DOI：
10.1038/ijo.2013.244
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发表时间：
2014-06
影响因子：
4.9
通讯作者：
Mills, J.
中科院分区：
文献类型：
--
作者：
Brite, J.;Laughon, S. k;Troendle, J.;Mills, J.
肥胖是先天性心脏病（CHD）的一个危险因素，但该风险是否与糖代谢异常无关尚不清楚。关于超重状态是否会增加风险的数据也是相互矛盾的。我们纳入了121815例分娩，来自一项队列研究，安全劳动联盟，排除了电子病历中记录的孕前糖尿病妇女。通过病历出院总结确定CHD。计算孕前体重指数（BMI）超重（25至<30 kg/m2）、肥胖（30至<40 kg/m2）和病态肥胖（≥40 kg/m2）与正常体重（18.5至<25 kg/m2）妇女相比，以及合并肥胖组（≥30 kg/m2）的特定CHD的校正比值比（OR）。对口服葡萄糖耐量试验（OGTT）结果进行了调整（如可用），作为器官形成时存在的潜在异常葡萄糖代谢的代表。有1388例（1%）婴儿患有CHD。超重（OR=1.15 95% CI：1.01-1.32）、肥胖（OR=1.26 95% CI：1.09，1.44）和病态肥胖（OR=1.34 95% CI：1.02-1.76）的女性比正常体重的女性有更大的新生儿CHD的几率（趋势P< 0.001）。肥胖妇女（BMI ≥30 kg/m2）生下圆锥动脉干缺损（OR=1.34 95%CI：1.04-1.72）、房间隔缺损（OR =1.22 95%CI：1.04-1.43）和室间隔缺损（OR=1.38 95%CI：1.06-1.79）的几率较高。在调整OGTT后，肥胖仍然是CHD风险的重要预测因素。母亲体重等级的增加与冠心病风险的增加有关。在肥胖女性中，糖代谢异常不能完全解释冠心病风险增加的原因;其他肥胖相关因素是否具有致畸性需要进一步研究。
Obesity is a risk factor for congenital heart defects (CHD), but whether risk is independent of abnormal glucose metabolism is unknown. Data on whether overweight status increases risk is also conflicting. We included 121815 deliveries from a cohort study, the Consortium on Safe Labor, after excluding women with pregestational diabetes as recorded in the electronic medical record. CHD were identified via medical record discharge summaries. Adjusted odds ratios (OR) for any CHD were calculated for prepregnancy body mass index (BMI) categories of overweight (25 to <30 kg/m2), obese (30 to <40 kg/m2), and morbidly obese (≥40 kg/m2) compared to normal weight (18.5 to <25 kg/m2) women, and for specific CHD with obese groups combined (≥30 kg/m2). A sub-analysis adjusting for oral glucose tolerance test (OGTT) results where available was performed as a proxy for potential abnormal glucose metabolism present at the time of organogenesis. There were 1388 (1%) infants with CHD. Overweight (OR=1.15 95% CI: 1.01–1.32), obese (OR=1.26 95% CI: 1.09, 1.44), and morbidly obese (OR=1.34 95% CI: 1.02–1.76) women had greater odds of having a neonate with CHD than normal weight women (P< 0.001 for trend). Obese women (BMI ≥30 kg/m2) had higher odds of having an infant with conotruncal defects (OR=1.34 95%CI: 1.04–1.72), atrial septal defects (OR =1.22 95% CI: 1.04–1.43), and ventricular septal defects (OR=1.38 95% CI: 1.06–1.79). Being obese remained a significant predictor of CHD risk after adjusting for OGTT. Increasing maternal weight class was associated with increased risk for CHD. In obese women, abnormal glucose metabolism did not completely explain the increased risk for CHD; the possibility that other obesity-related factors are teratogenic requires further investigation.
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影响因子：
9.8
作者：
Gilboa, Suzanne M.;Correa, Adolfo;Riehle-Colarusso, Tiffany J.
通讯作者：
Riehle-Colarusso, Tiffany J.
DOI：
10.1002/bdra.20620
发表时间：
2010-01-01
影响因子：
--
作者：
Blomberg, Marie I.;Kallen, Bengt
通讯作者：
Kallen, Bengt
影响因子：
9.8
作者：
Zhang J;Troendle J;Reddy UM;Laughon SK;Branch DW;Burkman R;Landy HJ;Hibbard JU;Haberman S;Ramirez MM;Bailit JL;Hoffman MK;Gregory KD;Gonzalez-Quintero VH;Kominiarek M;Learman LA;Hatjis CG;van Veldhuisen P;Consortium on Safe Labor
通讯作者：
Consortium on Safe Labor
影响因子：
1
作者：
Strickland MJ;Riehle-Colarusso TJ;Jacobs JP;Reller MD;Mahle WT;Botto LD;Tolbert PE;Jacobs ML;Lacour-Gayet FG;Tchervenkov CI;Mavroudis C;Correa A
通讯作者：
Correa A
影响因子：
4.9
作者：
Kelly, T.;Yang, W.;He, J.
通讯作者：
He, J.