母亲年龄与子代先天性心脏病的关联--一项巢式病例对照研究  

Association between maternal age and congenital heart disease in offspring:a nested case-control study

作　　者：马晓菲 易容松 刘柳 张玉 曾定元 韩咏 MA Xiao-fei;YI Rong-song;LIU Liu;ZHANG Yu;ZENG Ding-yuan;HAN Yong(Department of Neonatology,Liuzhou Hospital,Guangzhou Women and Children Medical Center,Liuzhou,Guangxi 545000,China;不详)

机构地区：[1]广州市妇女儿童医疗中心柳州医院新生儿科,广西柳州545000 [2]广州市妇女儿童医疗中心柳州医院儿内科,广西柳州545000 [3]柳州市妇幼保健院儿保科 [4]广西高龄孕产妇出生队列研究重点实验室

出　　处：《现代预防医学》2024年第13期2369-2374,共6页Modern Preventive Medicine

基　　金：广西科技计划项目(桂科AB18126056);柳州市科技局科技创新能力与条件建设计划项目(2022SB023)。

摘　　要：目的探讨母亲生育年龄与子代发生先天性心脏病(congenital heart disease,CHD)的关联。方法利用2020年1月1日—2022年12月31日广西壮族自治区柳州地区助产机构出生的活产新生儿CHD筛查数据,分为有CHD组1117例、无CHD组107458例(已排除未定期产检者及母亲生育年龄信息缺失者),使用倾向性评分匹配法对两组数据进行匹配。将母亲生育年龄分为<20岁、20~24岁、25~29岁、30~34岁、≥35岁组5个类别,以25~29岁组为参照组,采用多因素logistic回归模型进行分析不同分娩年龄组母亲与子代发生CHD之间的关系。使用限制性立方样条曲线进一步分析母亲生育年龄与子代CHD的非线性关系。结果经倾向性评分匹配后,有CHD组1117例,无CHD组3148例(对照组)。矫正后的logistic回归模型分析显示,与母亲年龄25~29岁相比,<20岁组及≥35岁组子代发生房间隔缺损(atrial septal defect,ASD)风险明显增加并具有统计学意义(OR=5.38,95%C1:2.96~9.79;OR=1.43,95%C1:1.01~2.03);≥35岁组子代室间隔缺损(ventricular septal defect,VSD)风险明显增加并具有统计学意义(OR=1.51,95%C1:1.04~2.19)。限制性立方样条及阈值分析显示,母亲生育年龄与子代发生CHD、ASD、VSD的风险呈曲线关系,分娩年龄>25.43岁时子代发生CHD风险随着分娩年龄增加(OR=1.04,95%C1:1.02~1.06);分娩年龄>32.04岁时子代发生VSD风险随着分娩年龄增加(OR=1.16,95%C1:1.09~1.24);而分娩年龄<23.75岁时随着分娩年龄增加子代发生ASD风险减小(OR=0.69,95%C1:0.58~0.82)。结论母亲生育年龄是子代发生CHD的独立危险因素。应鼓励妇女适龄婚育,对于低龄及大龄妇女应进一步合理指定筛查政策,加强产前筛查等。Objective To explore the relationship between maternal childbearing age and congenital heart disease(CHD)in offspring.Methods Based on the CHD screening data of live births born in midwifery institutions in Liuzhou area of Guangxi Zhuang Autonomous Region from January 1,2020 to December 31,2022,they were divided into CHD group(n=1117)and non-CHD group(n=107458).The data of the two groups were matched by propensity score matching method.The childbearing age of mothers was divided into five groups:<20 years old,20 years old,24 years old,25 years old,29 years old,30 years old,34 years old,and≥35 years old.The multivariate logistic regression model was used to analyze the relationship between mothers and their offspring with congenital heart disease in different childbirth age groups.The restricted cubic spline curve was used to further analyze the nonlinear relationship between maternal childbearing age and offspring CHD.Results There were 1117 cases in CHD group and 3148 cases in control group without CHD.The corrected Logistic regression model analysis showed that the risk of atrial septal defect(ASD)in offspring of<20 years old group and≥35 years old group was significantly higher than that of mothers aged 25 to 29 years old(OR=5.38,95%CI:2.96-9.79;OR=1.43,95%CI:1.01-2.03).The risk of ventricular septal defect(VSD)was significantly increased in the offspring≥35 years old(OR=1.51,95%CI:1.04-2.19).Restricted cubic spline and threshold analysis showed that there was a curvilinear relationship between maternal childbearing age and the risk of CHD,ASD,and VSD in offspring.The risk of CHD in offspring increased with childbirth age(OR=1.04,95%CI:1.02-1.06)when childbirth age was more than 25.43 years old,and VSD risk increased with childbirth age when childbirth age>32.04 years old(OR=1.16,95%CI:1.09-1.24).When the delivery age was less than 23.75 years old,the risk of ASD in offspring decreased with the increase of delivery age(OR=0.69,95%CI:0.58-0.82).Conclusion Maternal childbearing age is an independent risk f

关 键 词：先天性心脏病 母亲生育年龄 房间隔缺损 室间隔缺损 动脉导管未闭 

分 类 号：R541.1[医药卫生—心血管疾病]