Assessing the risk of preterm birth for newborns with congenital heart defects conceived following infertility treatments: a population-based study

被引：2

作者：

Tararbit, Karim ^{[1
]}

Lelong, Nathalie ^{[1
,4
,15
,16
]}

Goffinet, Francois ^{[1
,2
,8
,9
,15
,16
]}

Khoshnood, Babak ^{[1
,4
,15
,16
]}

Bonnet, Damien ^{[3
]}

Calderon, Johanna ^{[4
]}

Candilis, Drina ^{[5
]}

Delezoide, Anne-Lise ^{[6
]}

De Vigan, Catherine ^{[7
]}

Houyel, Lucile ^{[10
]}

Jouannic, Jean-Marie ^{[11
]}

Magnier, Suzel ^{[12
]}

Magny, Jean-Francois ^{[13
]}

Rambaud, Caroline ^{[14
]}

Salomon, Dominique ^{[4
]}

Vodovar, Veronique ^{[4
,15
,16
]}

Thieulin, Anne-Claire ^{[15
,16
]}

Andrieu, Thibaut ^{[15
,16
]}

Chausson, Maggy ^{[17
]}

Brinis, Anissa ^{[17
]}

Faure, Laure ^{[17
]}

Delattre, Maryline ^{[17
]}

Treluyer, Jean-Marc ^{[17
]}

Breart, Gerard

Cabrol, Dominique

Serraf, Alain

Sidi, Daniel

Voyer, Marcel

机构：

[1] Paris Descartes Univ, Obstet Perinatal & Pediat Epidemiol Res Team EPOP, Ctr Epidemiol & Stat,UMR 1153, Sorbonne Paris Cite CRESS,DHU Risks Pregnancy,INS, Paris, France

[2] Univ Paris 05, Hop Cochin St Vincent Paul, AP HP, Matemite Port Royal, Paris, France

[3] Univ Paris 05, Hop Necker Enfants Malades, AP HP, Ctr Reference M3C, Paris, France

[4] INSERM U1153, Paris, France

[5] Univ Paris Diderot, Paris, France

[6] Univ Paris Diderot, Hop Robed Debre, AP HP, Serv Biol Dev, Paris, France

[7] INSERM 1153, Paris, France

[8] Univ Paris 05, Grp Hosp Cochin Hotel Dieu, AP HP, Maternite Port Royal, Paris, France

[9] Univ Paris 05, INSERM U953, Paris, France

[10] Hop Marie Lannelongue, Serv Chirurg Cardiopathies Congenitales, Le Plessis Robinson, France

[11] Hop Trousseau, AP HP, Ctr Pluridisciplinaire Diagnost Prenatal, UPMC, Paris, France

[12] Hop Robert Debre, AP HP, Serv Cardiol, Paris, France

[13] Inst Puericulture & Perinatol, Serv Neonatol, Paris, France

[14] Hop Raymond Poincarre, AP HP, Serv Anat & Cytol Pathol Med Legale, UVSQ, Garches, France

[15] URC Paris Ctr, Paris, France

[16] CIC Cochin Necker Mere Enfant, Paris, France

[17] Univ Paris 05, Grp HospCochin Hotel Dieu, AP HP, Paris, France

来源：

OPEN HEART | 2018年 / 5卷 / 02期

关键词：

D O I：

10.1136/openhrt-2018-000836

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To quantify the risk of preterm birth (PTB) for newborns with congenital heart defects (CHDs) conceived following infertility treatments, and to examine the role of multiple pregnancies in the association between infertility treatments and PTB for newborns with CHD. Methods We used data from a population-based, prospective cohort study (EPICARD EPIdemiologie des CARDiopathies congenitales) including 2190 newborns with CHD and excluding cases with atrial septal defects born to women living in the Greater Paris area between May 2005 and April 2008. Statistical analysis included logistic regression to take into account potential confounders (maternal characteristics, invasive prenatal testing, CHD prenatal diagnosis, medically induced labour/caesarean section before labour, birth year). The role of multiple pregnancies was assessed using a path-analysis approach, allowing decomposition of the total effect of infertility treatments on the risk of PTB into its indirect (mediated by the association between infertility treatments and multiple pregnancies) and direct (mediated by mechanisms other than multiple pregnancies) effects. Results PTB occurred for 40.6% (95% CI 28.7 to 52.5) of newborns with CHD conceived following infertility treatments vs 12.7% (95% CI 11.3 to 14.2) for spontaneously conceived newborns (p<0.001). After taking into account potentially confounding factors, infertility treatments were associated with a 5.0-fold higher odds of PTB (adjusted OR=5.0, 95% CI 2.9 to 8.6). Approximately two-thirds of this higher risk of PTB associated with infertility treatments was an indirect effect (ie, due to multiple pregnancies) and one-third was a direct effect (ie, not mediated by multiple pregnancies). Conclusion Newborns with CHD conceived following infertility treatments are at a particularly high risk of PTB, exposing over 40% of them to the 'double jeopardy' of CHD and PTB.

引用

页数：9

共 30 条

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