Parity and the risk of Down's syndrome.
Parity and the risk of Down's syndrome.
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产次和唐氏综合症的风险。
DOI：
10.1093/aje/kwg193
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发表时间：
2003
影响因子：
5
通讯作者：
Edwards,KarenL
中科院分区：
文献类型：
--
作者：
Doria-Rose,VPaul;Kim,HanS;Augustine,ElizabethTJ;Edwards,KarenL
由于对产妇年龄控制不足和/或未能考虑到低产次和高产次妇女之间产前诊断和终止妊娠的区别使用，对将产次视为唐氏综合征风险因素的研究的解释受到阻碍。在这项病例对照研究中，作者对母亲年龄进行了精确匹配，最大限度地减少了混杂因素，并评估了差异终止的潜在影响。从1984年到1998年，使用华盛顿州的出生证明，共确定了898例唐氏综合征和4,488例对照。有一种趋势，即随着年轻（年龄<35岁）和老年（年龄≥35岁）母亲产次的增加，唐氏综合征的风险也会增加。仅限于没有子宫穿刺指征的妇女（对她们来说，差异性终止妊娠是不可能的）导致优势比变钝;然而，均等的趋势仍然存在。限制后，优势比高达1.65（95%置信区间：1.13，2.40），在年轻妇女的奇偶性为3（与奇偶性为零）和2.41（95%置信区间：1.41，4.12），在老年妇女的奇偶性为4或更多。尽管由于出生证明上的胎儿穿刺术报告不足，老年妇女的优势比可能偏高，但这些数据支持了产次与唐氏综合征之间的关联。
Interpretation of studies that have examined parity as a risk factor for Down’s syndrome has been hindered by inadequate control for maternal age and/or failure to account for the differential use of prenatal diagnosis and pregnancy termination between low-parity and high-parity women. In this case-control study, the authors used exact matching on maternal age–minimize confounding and evaluated the potential impact of differential termination. A total of 898 cases of Down’s syndrome and 4,488 controls were identified using Washington State birth certificates from 1984–1998. There was a trend towards increasing risk of Down’s syndrome with increasing parity in both younger (age <35 years) and older (age ≥35 years) mothers. Restriction to women with no indication of amniocentesis (for whom differential termination is unlikely) resulted in a blunting of the odds ratios; however, a trend for parity remained. After restriction, odds ratios were as high as 1.65 (95% confidence interval: 1.13, 2.40) in younger women with a parity of three (compared with a parity of zero) and 2.41 (95% confidence interval: 1.41, 4.12) in older women with a parity of four or more. Although the odds ratios for older women were probably biased upwards because of underreporting of amniocentesis on birth certificates, these data support an association between parity and Down’s syndrome.