孕妇围孕期风险因素暴露与子代发生尿道下裂或隐睾的关联  

Association between maternal peri-conceptional exposures and risk of hypospadias and cryptorchidism in offspring

作　　者：谢双华 岳文涛 张恩婕 高屾 苏少飞 郝永秀 张玥[2] 刘建辉 阴赪宏[1] 刘瑞霞 Xie Shuanghua;Yue Wentao;Zhang Enjie;Gao Shen;Su Shaofei;Hao Yongxiu;Zhang Yue;Liu Jianhui;Yin Chenghong;Liu Ruixia(Department of Central Laboratory,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Department of Research Management,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;School of Public Health,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院中心实验室,北京100026 [2]首都医科大学附属北京妇产医院/北京妇幼保健院科技处,北京100026 [3]首都医科大学公共卫生学院,北京100069

出　　处：《中华医学杂志》2024年第26期2424-2430,共7页National Medical Journal of China

基　　金：首都卫生发展科研专项(2024-2G-2118);北京市卫生系统高层次公共卫生技术人才建设项目领军人才(2022-1-003);北京市医院管理中心“青苗”计划(QML20231402);国家重点研发计划(2016YFC1000101);北京市科学技术协会青年人才托举工程(BYESS2022200);首都医科大学附属北京妇产医院中青年学科骨干培养专项(FCYY202102)

摘　　要：目的探讨孕妇围孕期风险因素暴露与子代尿道下裂或隐睾发生的关联。方法前瞻性选取2018年2月至2020年12月在首都医科大学附属北京妇产医院研究中心参加“中国出生人口队列”研究且分娩男性新生儿的孕妇为研究对象。所有研究对象于孕6~13+6周入组,采用问卷调查收集围孕期危险因素信息,通过超声检查和出生时临床查体获取尿道下裂或隐睾结局信息。采用多因素logistic回归模型分析发生尿道下裂或隐睾的相关因素。结果共纳入15833例孕妇,年龄为(31.81±3.84)岁,其子代诊断为尿道下裂或隐睾为113例(尿道下裂42例,隐睾69例,尿道下裂及隐睾2例),发生率为7.14‰。多因素logistic回归分析结果显示,既往出生缺陷孕育史(OR=3.01,95%CI:1.09~8.35)、孕前患乙型肝炎(OR=4.74,95%CI:1.10~20.42)、胎儿生长受限(OR=4.02,95%CI:2.10~7.68)、孕前开始服用复合维生素(OR=1.98,95%CI:1.12~3.52)和很少在家烹饪(OR=2.17,95%CI:1.23~3.82)是子代发生尿道下裂或隐睾的相关因素(均P<0.05)。结论孕妇围孕期BMI≥28 kg/m 2、患乙型肝炎、既往出生缺陷孕育史、胎儿生长受限、孕前开始服用复合维生素和很少在家烹饪与子代尿道下裂或隐睾发生相关。Objective To investigate the relationship between maternal exposures to peri-conceptional risk factors and the risk of hypospadias and cryptorchidism in offspring.Methods Pregnant women who delivered male newborns and participated in the China birth cohort study between February 2018 and December 2020 at the research center of Beijing Obstetrics and Gynecology Hospital,Capital Medical University were selected for the study.All were enrolled at 6-13+6 weeks of their gestation.Baseline risk factor information was collected by questionnaire survey.Information on the outcome of hypospadias and cryptorchidism was obtained by clinical examination at birth and ultrasonography.Logistic regression was used to analyze the Odds Ratio(OR)and 95%Confidence Interval(95%CI)of each factor with respect to the onset of the outcome.Results A total of 15,833 pregnant women with an average age of(31.81±3.84)years were included.Among their offsprings,113 were diagnosed as hypospadias or cryptorchidism(42 hypospadias,69 cryptorchidism,and 2 both hypospadias and crypterchidism),with an incidence of 7.14‰.The results of multivariate logistic regression analysis showed that mothers with pregnancy history of birth defects(OR=3.01,95%CI:1.09-8.35),with preconception Hepatitis B infection(OR=4.74,95%CI:1.10-20.42),fetal growth restriction(OR=4.02,95%CI:2.10-7.68),multivitamin use since preconception(OR=1.98,95%CI:1.12-3.52),and never cook and eat at home(OR=2.17,95%CI:1.23-3.82)were risk factors for hypospadias and cryptorchidism(all P<0.05).Conclusions Obesity in early pregnancy,preconception Hepatitis B infection,pregnancy history of birth defects,fetal growth restriction,multivitamin use before pregnancy,and rarely cook and eat at home were associated with an increased risk of hypospadias or cryptorchidism in their offsprings.

关 键 词：尿道下裂 隐睾 危险因素 队列研究 

分 类 号：R714.7[医药卫生—妇产科学]