科研之友
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摘要
Medical science is advancing. Consequently, the survival rate of children born with genetic congenital anomalies has improved. However, mothers of those children who survive are under severe stress due to the demands of caregiving. Giving birth and raising children with congenital anomalies are a major challenge for their parents, mothers in particular, and as a result there may be an increase in the risk of morbidity and mortality among these women. The current study was conducted to ascertain the association between delivering and caring of infants with congenital birth defects and the mortality rate among their mothers. This research was conducted in Denmark, and it was registry based. Data were collected from Danish Civil Registration System and Medical Birth Registry. Details of deliveries between 1979 and 2010 were gathered, and the cohort included 455,250 mothers who delivered during the study period. The anomaly cohort included 41,508 women who delivered infants with a serious congenital anomaly. For each woman in this group, 10 women who delivered normal infants were selected. The year of delivery, maternal age, and parity (1, 2, and >= 3 children) were matched. Hazard ratios (HRs) were adjusted on the basis of income, immigration, and marital status. Medical history of the women, such as hypertension, depression, diabetes, previous abortion, complications during pregnancy, and drug-or alcohol-related diseases, was taken into consideration. The Charlson Comorbidity Index score on comorbid conditions was also recorded. Cases were segregated into all-cause mortality and cause-specific mortality. Factor-based comparison between the 2 groups shows that death rate in the anomaly cohort was 1.60 per 1000 (n = 1275), whereas it was 1.24 per 1000 (n = 10,112) in the control cohort. Themortality rate difference was 0.33 per 1000 (95% confidence interval [CI], 0.24-0.42) with the adjusted HR at 1.22 (95% CI, 1.15-1.29). Deaths among mothers of children with congenital abnormalities were mostly due to cardiovascular ailments, respiratory disorders, and other natural causes. The variation in cardiovascular-related cause of death was 0.05 per 1000 person-years (95% CI, 0.02-0.08; adjusted HR, 1.26 [95% CI, 1.04-1.53]). The difference in rate of deaths due to natural causes was 0.11 per 1000 person-years (95% CI, 0.07-0.15; adjusted HR, 1.50 [95% CI, 1.27-1.76]). The difference due to unnatural causes and accidents was not statistically different. Thus, women giving birth to infants with congenital anomalies are at a small but statistically significant increased mortality risk. Although interesting, the clinical importance and causal relationship of this finding are yet to be ascertained.
- 出版日期2017-4
