RISK FACTORS FOR PULMONARY HYPERTENSION OF THE NEWBORN

描述：（改编自研究者摘要）持续性肺部 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，影响约1/1250活产 足月儿;即使有复杂和高风险的干预措施，PPHN也会导致 高死亡率和发病率。 这一缺陷是由于 胎儿肺血管肌肉化不适当， 和人类的证据一致表明，母亲吸烟， 产前暴露于非甾体抗炎药（NSAID）， 特别是阿司匹林或布洛芬，可能在病因学中起作用。 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% ），测试这些假设是相当大的公众。 健康的重要性。 研究者建议进行一项多中心病例对照研究， PPHN与母亲暴露于吸烟和NSAID有关。 他们还将 评估其他潜在的产前风险因素， 细胞样本以备将来分析。 将有560例婴儿PPHN和四个对照每例（2240）。 所有对照组均来自病例的出生医院; 对照组将有PPHN以外的畸形，一半将有正常 阵 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家妇产医院和三级医院， 费城和多伦多。 受试者的母亲将接受 在交付后六个月内电话;标准化问卷将 详细询问人口因素;生殖、医疗和 妊娠病史;药物使用（包括详细关注 使用非处方止痛/解热药物）、吸烟，以及 营养 因为新兴的基因研究表明， NSAID对可能与PPHN病因相关的途径的影响，口腔拭子 也将被收集和存储用于未来的分析。 接触率 将比较病例组和对照组母亲之间的相对风险 将估计，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.