RISK FACTORS FOR PULMONARY HYPERTENSION OF THE NEWBORN

描述：(改编自《调查者摘要》)持续性肺 新生儿高血压(PPHN)，以前称为持续性胎儿 循环，是一种出生缺陷，大约每1250名活产儿中就有1人受到影响 足月儿；即使进行复杂和高风险的干预，PPHN也会导致 相当高的死亡率和发病率。这一缺陷是由于 不适当的胎儿肺血管肌肉化和实验性 而人类证据一直表明，母亲吸烟和 产前暴露于非类固醇抗炎药(NSAIDs)， 尤其是阿司匹林或布洛芬，可能在此的病因中起作用。 条件。因为这些暴露是相当普遍的(例如，布洛芬 目前在怀孕前三个月或怀孕后期服用的比例分别为15%和3.2% 分别在女性中)，验证这些假设是相当公开的 健康的重要性。 研究人员建议进行一项多中心病例对照研究 PPHN与母亲吸烟和非甾体抗炎药暴露的关系。他们还将 评估其他潜在的产前风险因素，收集和储存口腔 用于未来分析的细胞样本。 将有560名婴儿患有PPHN，每个病例有4名对照(2240名)。 所有的控制措施都将从病例的产科医院中抽取； 对照组将有PPHN以外的畸形，而一半的人将有正常 编队。病例和对照将在出生后5个月内确定 在波士顿周边地区的88家产科和三级医院， 费城和多伦多。受试者的母亲将接受以下采访 在交货后六个月内打电话；标准化问卷将 详细询问人口统计因素；生殖、医学和 怀孕病史；用药情况(包括对 使用非处方止痛药/退烧药)、吸烟和 营养。因为新出现的基因研究表明， 可能与PPHN、口腔拭子病原学有关的途径上的非类固醇抗炎药 也将被收集和存储，以供将来分析。暴露流行率 将在病例母亲和对照母亲之间以及相关风险之间进行比较 将被估计，控制潜在的混杂因素。

DESCRIPTION: (Adapted from Investigator's Abstract) Persistent pulmonary hypertension of the newborn (PPHN), previously called persistent fetal circulation, is a birth defect affecting approximately 1 in 1250 liveborn term infants; even with complex and high-risk interventions, PPHN results in substantial mortality and morbidity. This defect results from the inappropriate muscularization of fetal pulmonary vessels, and experimental and human evidence consistently suggests that maternal cigarette smoking and antenatal exposure to non-steroidal anti-inflammatory drugs (NSAIDs), particularly aspirin or ibuprofen, may play a role in the etiology of this condition. Because these exposures are quite prevalent (e.g., ibuprofen is currently taken in the first trimester or later in pregnancy by 15% and 3.2% of women, respectively), testing these hypotheses is of considerable public health importance. The investigators propose to conduct a multicenter case-control study of PPHN in relation to maternal exposure to smoking and NSAIDs. They will also assess other potential antenatal risk factors and collect and store buccal cell specimens for future analyses. There will be 560 case infants with PPHN and four controls per case (2240). All controls will be drawn from the birth hospitals of cases; half the controls will have malformations other than PPHN, and half will have normal formations. Cases and controls will be identified within 5 months of birth at 88 birth and tertiary hospitals in the areas surrounding Boston, Philadelphia, and Toronto. Mothers of subjects will be interviewed by telephone within six months of delivery; a standardized questionnaire will inquire in detail about demographic factors; reproductive, medical, and pregnancy illness histories; medication use (including a detailed focus on use of over-the-counter analgesic/antipyretic medications), smoking, and nutrition. Because of emerging genetic research suggesting an effect of NSAIDs on pathways possibly related to the etiology of PPHN, buccal swabs will also be collected and stored for future analyses. Exposure prevalences will be compared between mothers of cases and controls and relative risks will be estimated, controlling for potential confounding factors.