PDF(Pubmed)
Abstract：
To explore the associations between high uterine artery pulsatility index (UtA-PI) values and congenital heart disease (CHD) risk and whether they differed between singleton and multiple pregnancies. This hospital-based cohort study involving 52,047 pregnant women who underwent prenatal examinations from 2012 to 2016. Infants born to the included pregnant women were followed until 42 days after birth to identify those with CHDs. Generalized estimating equations were used to estimate the associations of high right UtA-PI (> 95th percentile) values with maternal preeclampsia and fetal CHDs. Logistic regression analyses were conducted using path analysis models to quantify the effect of high right UtA-PI values on fetal CHD risk. A total of 42,552 women and 43,470 infants (147 with CHDs) were included. Preeclampsia risk was associated with a high right UtA-PI in singleton-pregnant women (adjusted PR, 3.01; 95% CI 2.57-3.52). CHD risk was marginally associated with a high right UtA-PI in singleton-pregnant women (adjusted PR, 2.26, 95% CI 1.03-4.95). Considering only two factors, 96.0% of the fetal CHD risk was mediated by preeclampsia in singleton-pregnant women, while 93.8% of the risk was related to a high right UtA-PI in multiple-pregnant women. A high right UtA-PI was marginally associated with an increased fetal CHD risk in singleton-pregnant women and might play an important role in multiple-pregnant women. Further studies are warranted to confirm these findings given the high loss to follow-up rate.
摘要：
探讨高子宫动脉搏动指数（UtA-PI）值与先天性心脏病（CHD）风险之间的关系，以及单胎和多胎妊娠之间是否存在差异。这项基于医院的队列研究涉及2012年至2016年接受产前检查的52,047名孕妇。对所包括的孕妇所生的婴儿进行随访，直到出生后42天，以确定患有CHD的婴儿。使用广义估计方程来估计高右UtA-PI（>95百分位数）值与母体先兆子痫和胎儿CHD的关联。使用路径分析模型进行Logistic回归分析，以量化高右UtA-PI值对胎儿CHD风险的影响。共包括42,552名妇女和43,470名婴儿（147名患有CHD）。先兆子痫风险与单胎孕妇的右UtA-PI高相关（调整后的PR，3.01；95%CI2.57-3.52）。CHD风险与单胎孕妇的右UtA-PI高相关(调整后的PR，2.26，95%CI1.03-4.95）。只考虑两个因素,在单胎孕妇中，96.0%的胎儿CHD风险是由先兆子痫介导的，而93.8%的风险与多胎孕妇的高右UtA-PI有关。高右UtA-PI与单胎孕妇的胎儿CHD风险增加略有相关，并且可能在多胎孕妇中起重要作用。鉴于随访率的高损失，需要进一步的研究来证实这些发现。
