母亲可改变的因素和先天性心脏缺陷的风险:系统审查和因果关系评估
Judith C Gomersall1, Vivienne M Moore2, Renae C Fernandez3
1School of Public Health and Lifecourse and Intergenerational Health Research Group, The University of Adelaide, Adelaide, South Australia, Australia judith.gomersall@adelaide.edu.au.
BMJ open
|August 24, 2024
概括
初级预防先天性心脏缺陷 (CHD) 需要了解因果因素. 孕产妇肥胖和先前存在的糖尿病与心血管疾病有很强的因果关系,需要有针对性的干预措施.
科学领域:
- 生殖健康 生殖健康
- 儿童心脏病学 儿童心脏病学
- 流行病学 流行病学
背景情况:
- 先天性心脏缺陷 (CHDs) 代表了全球健康的重大负担.
- 初级预防策略对于降低心脏病发病率至关重要.
- 识别因果性孕产妇风险因素对于有效的预防至关重要.
研究的目的:
- 系统地审查和评估母因子和心血管疾病之间的因果关系.
- 用布拉德福德山标准评估因果关系证据的强度.
主要方法:
- 进行了对评论的系统审查,搜索了PubMed,Embase和Episteminokos.
- 选择了符合条件的流行病学研究审查,并对偏见进行了评估.
- 应用了布拉德福德希尔标准来确定因果证据的强度.
主要成果:
- 强有力的因果证据将孕产妇肥胖 (怀孕前和怀孕初期) 和糖尿病与心血管疾病联系起来.
- 对于先前存在的高血压和先进的孕产妇年龄,发现了适度的因果证据.
- 在妊娠糖尿病,妊娠高血压,吸烟和饮酒方面观察到较弱的因果关系证据.
结论:
- 降低孕产妇肥胖和先前存在的糖尿病患病率可以降低心血管疾病的发病率.
- 建议对空气污染物和化学品等环境暴露进行进一步的研究,以加强预防策略.
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