■先天性椎体畸形的病因和危险因素在孤立病例中主要不清楚。此外,没有关于不同椎体异常亚组的危险因素的报告。因此,我们评估并确定了这些异常的潜在孕产妇风险因素,并假设糖尿病,其他慢性疾病,吸烟,肥胖,妊娠早期用药会增加先天性椎体畸形的风险。
■从1997年至2016年,在芬兰先天性畸形注册中确定了所有先天性椎骨异常的病例,用于这项基于全国注册的病例对照研究。随机选择五个没有椎骨畸形的匹配对照。分析的孕产妇危险因素包括孕产妇年龄,身体质量指数,奇偶校验,吸烟,流产史,慢性疾病,在怀孕早期购买处方药。
■注册搜索确定了256例先天性椎骨畸形。排除66例综合征病例后,190例非综合征畸形(74例地层缺陷,4分割缺陷,和112个混合异常)被纳入研究。母亲吸烟是形成缺陷的重要危险因素(调整后的比值比2.33,95%置信区间1.21-4.47)。此外,孕前糖尿病(校正比值比8.53,95%置信区间2.33~31.20)和类风湿性关节炎(校正比值比13.19,95%置信区间1.31~132.95)与混合性椎体异常相关.
孕前糖尿病和类风湿性关节炎与混合性椎体异常的风险增加相关。母亲吸烟会增加形成缺陷的风险,并且是先天性脊柱侧凸的可避免的风险因素。
■III.
UNASSIGNED: The etiology and risk factors of congenital vertebral anomalies are mainly unclear in isolated cases. Also, there are no
reports on the risk factors for different subgroups of vertebral anomalies. Therefore, we assessed and identified potential maternal risk factors for these anomalies and hypothesized that diabetes, other chronic diseases, smoking, obesity, and medication in early pregnancy would increase the risk of congenital vertebral anomalies.
UNASSIGNED: All cases with congenital vertebral anomalies were identified in the Finnish Register of Congenital Malformations from 1997 to 2016 for this nationwide register-based
case-control study. Five matched controls without vertebral malformations were randomly selected. Analyzed maternal risk factors included maternal age, body mass index, parity, smoking, history of miscarriages, chronic diseases, and prescription drug purchases in early pregnancy.
UNASSIGNED: The register search identified 256 cases with congenital vertebral malformations. After excluding 66 syndromic cases, 190 non-syndromic malformations (74 formation defects, 4 segmentation defects, and 112 mixed anomalies) were included in the study. Maternal smoking was a significant risk factor for formation defects (adjusted odds ratio 2.33, 95% confidence interval 1.21-4.47). Also, pregestational diabetes (adjusted odds ratio 8.53, 95% confidence interval 2.33-31.20) and rheumatoid arthritis (adjusted odds ratio 13.19, 95% confidence interval 1.31-132.95) were associated with mixed vertebral anomalies.
UNASSIGNED: Maternal pregestational diabetes and rheumatoid arthritis were associated with an increased risk of mixed vertebral anomalies. Maternal smoking increases the risk of formation defects and represents an avoidable risk factor for congenital scoliosis.
UNASSIGNED: III.