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The safety of pranlukast and montelukast during the first trimester of pregnancy: A prospective, two-centered cohort study in Japan 普鲁司特和孟鲁司特在妊娠早期的安全性:日本的一项前瞻性、双中心队列研究
IF 1.3 4区 医学 Pub Date : 2022-05-10 DOI: 10.1111/cga.12471
Shiro Hatakeyama, Mikako Goto, Ayaka Yamamoto, Jiro Ogura, Norikazu Watanabe, Seiji Tsutsumi, Naho Yakuwa, Ritsuko Yamane, Satoru Nagase, Kunihiko Takahashi, Rika Kosaki, Atsuko Murashima, Hiroaki Yamaguchi

For leukotriene receptor antagonists (LTRAs), especially pranlukast, safety data during pregnancy is limited. Therefore, we conducted a prospective, two-centered cohort study using data from teratogen information services in Japan to clarify the effects of LTRA exposure during pregnancy on maternal and fetal outcomes. Pregnant women who being counseled on drug use during pregnancy at two facilities were enrolled. The primary outcome of this study was major congenital anomalies. The incidence of major congenital anomalies in women exposed to montelukast or pranlukast during the first trimester of pregnancy was compared with that of controls. Logistic regression analysis was performed to analyze the effects of maternal LTRA use during the first trimester of pregnancy on major congenital anomalies. The outcomes of 231 pregnant women exposed to LTRAs (montelukast n = 122; pranlukast n = 106; both n = 3) and 212 live births were compared with those of controls. The rate of major congenital anomalies in the LTRA group was 1.9%. Multivariable logistic regression analysis revealed that LTRA exposure was not a risk factor for major congenital anomalies (adjusted odds ratio, 0.78; 95% confidence interval, 0.23–2.05; p = 0.653). In addition, no significant difference was detected in stillbirth, spontaneous abortion, preterm birth, and low birth weight between the two groups. The present study revealed that montelukast and pranlukast were not associated with the risk of major congenital anomalies. Our findings suggest that LTRAs could be safely employed for asthma therapy during pregnancy.

对于白三烯受体拮抗剂(LTRAs),特别是普鲁卡斯特,妊娠期间的安全性数据有限。因此,我们进行了一项前瞻性、双中心队列研究,使用来自日本致畸物信息服务的数据,以阐明妊娠期间LTRA暴露对母体和胎儿结局的影响。在两个机构接受怀孕期间药物使用咨询的孕妇被纳入研究。这项研究的主要结果是主要的先天性异常。在妊娠前三个月暴露于孟鲁司特或普鲁司特的妇女的主要先天性异常的发生率与对照组比较。采用Logistic回归分析分析妊娠前三个月产妇使用LTRA对主要先天性异常的影响。231例暴露于LTRAs的孕妇的结局(孟鲁司特n = 122;Pranlukast n = 106;n = 3)和212例活产婴儿与对照组比较。LTRA组重大先天性畸形发生率为1.9%。多变量logistic回归分析显示LTRA暴露不是主要先天性异常的危险因素(校正优势比,0.78;95%置信区间为0.23-2.05;p = 0.653)。此外,两组在死胎、自然流产、早产、低出生体重方面无显著差异。目前的研究显示孟鲁司特和普鲁司特与重大先天性异常的风险无关。我们的研究结果表明,LTRAs可以安全地用于妊娠期间的哮喘治疗。
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引用次数: 1
Excessive folic acid intake combined with undernutrition during gestation alters offspring behavior and brain monoamine profiles 过量的叶酸摄入与妊娠期营养不良相结合会改变后代的行为和大脑单胺谱
IF 1.3 4区 医学 Pub Date : 2022-05-09 DOI: 10.1111/cga.12472
Tetsuo Ono, Kodai Hino, Tomoko Kimura, Yasuhiro Uchimura, Takashi Ashihara, Takako Higa, Hideto Kojima, Takashi Murakami, Jun Udagawa

Dietary folic acid augmentation during gestation reduces neurodevelopmental disorder risk in offspring; however, it is still unclear if excessive maternal folic acid intake can impair brain function in offspring. We examined if excessive folic acid intake throughout gestation altered the behavior of male offspring under poor nutrition during early gestation (E5.5–E11.5). Dams were divided into four groups: control (CON, 2 mg folic acid/kg of food), excessive folic acid fortification (FF, 10 mg folic acid/kg of food), undernutrition (UN, 40% food reduction from E5.5–E11.5), and excessive folic acid fortification plus undernutrition (UN-FF). Excess maternal folic acid fortification induced hyperactivity in the open-field and lower anxiety-like behavior in the elevated plus maze at 9 weeks of age. These behavioral changes were accompanied by reduced dopamine in the prefrontal cortex (PFC), norepinephrine in the amygdala, and 5-hydroxytryptamine (5-HT) in the dorsal midbrain (DM), PFC, and amygdala where 5-HT neurons project from the DM. Furthermore, canonical discriminant analysis, including dopamine and DOPAC concentrations in the PFC, norepinephrine concentrations in the PFC, amygdala, and pons, and 5-HT and 5-HIAA concentrations in the amygdala and DM, correctly classified 73.5% of the offspring in CON, FF, UN, and UN-FF groups. The first discriminant function mainly classified groups based on nutritional status, whereas the second function mainly classified groups based on folic acid intake. Our study suggests that combined transformations of brain monoamine profiles by maternal undernutrition and excess folic acid intake is involved in the behavioral alteration of offsprings.

妊娠期饮食中增加叶酸可降低后代神经发育障碍风险;然而,目前尚不清楚母亲过量摄入叶酸是否会损害后代的大脑功能。我们研究了在整个妊娠期过量摄入叶酸是否会改变妊娠早期营养不良的雄性后代的行为(E5.5-E11.5)。将白羊分为4组:对照组(CON, 2 mg叶酸/kg食物)、过量叶酸强化组(FF, 10 mg叶酸/kg食物)、营养不足组(UN,从e5.5 ~ e11.5减少40%食物)、过量叶酸强化加营养不足组(UN-FF)。在9周龄时,过量的母体叶酸强化诱导了开阔场地的多动症和高加迷宫中焦虑样行为的降低。这些行为变化伴随着前额皮质(PFC)、杏仁核中去甲肾上腺素的减少,以及中脑背侧(DM)、PFC和杏仁核中5-羟色胺(5-HT)的减少,其中5-HT神经元从DM投射出来。此外,典型判别分析包括PFC中的多巴胺和DOPAC浓度,PFC、杏仁核和脑轴中的去甲肾上腺素浓度,以及杏仁核和DM中的5-HT和5-HIAA浓度,CON、FF、UN和UN-FF组的后代正确分类率为73.5%。第一个判别函数主要根据营养状况进行分类,第二个判别函数主要根据叶酸摄入量进行分类。我们的研究表明,母亲营养不良和过量叶酸摄入导致的大脑单胺谱的联合转变与后代的行为改变有关。
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引用次数: 1
Fetal phenotype of SLC35A2-CDG: Enlarged cisterna magna on ultrasound SLC35A2-CDG胎儿表型:超声显示大池增大
IF 1.3 4区 医学 Pub Date : 2022-05-09 DOI: 10.1111/cga.12473
Li Zhen, Gui-Lan Chen, Yan-Lin Li, Dong-Zhi Li
Congenital disorders of glycosylation (CDG) are rare conditions caused by genetic defects in glycan synthesis, processing or trans-port that are required in formation of glycoproteins and glycolipids. 1 Glycosylation involves an ever growing number of genes, encoding different proteins or enzymes. A defect of one of these genes can lead to a subtype of CDG, potentially affecting multiple organ sys-tems and always including an important neurological component. For example, CDG type IIm is known as SLC35A2-CDG due to a hemizygous or heterozygous variant in the X-linked gene SLC35A2 that encodes the major Golgi-localized UDP-galactose transporter required for proper protein and lipid glycosylation. 2 The manifesta-tions of SLC35A2-CDG include seizures, failure to thrive, developmental delay, and intellectual disability. Prenatal diagnosis is uncommon in SLC35A2-CDG cases. We here report such a fetal case with an enlarged cisterna magna identified by prenatal ultrasound. revealed An
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引用次数: 0
Upper lip abscess due to congenital sinus infection: A case report. 先天性鼻窦感染致上唇脓肿1例。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-02-17 DOI: 10.1111/cga.12459
Hideto Imura, Ichinnorov Chimedtseren, Hiroo Furukawa, Masaaki Ito, Nagato Natsume
Congenital sinuses of the upper lip are cleft lip microforms that are common in the lower lip and accompany cleft lips. In western populations, the prevalence of lower lip vermilion is 0.001%, and upper lip sinuses are rarer than lower lip vermilion. 1 Herein, we present a case of an upper lip abscess secondary to an infected congenital fistula.
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引用次数: 0
Application of geometric morphometrics for facial congenital anomaly studies. 几何形态计量学在面部先天性异常研究中的应用。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-02-17 DOI: 10.1111/cga.12461
Motoki Katsube, Shigehito Yamada, Natsuko Utsunomiya, Naoki Morimoto

The face is a small complex three-dimensional (3D) structure composed of various bones and essential organs. Congenital anomalies of those organs represent various deformities; therefore, their quantification has been challenging. Linear measurements, such as lengths or angles between landmarks, called conventional morphometrics, have been used to quantify their phenotypes usually using 2D images, such as photographs or X-ray images. During analysis, geometric information, which refers to the relative position of each structure, is lost. Geometric morphometrics (GM) uses shape configurations, including anatomical landmarks, which can retain geometric information throughout analysis and can help visualize the results, making it tremendously advantageous compared to conventional methods. Morphometric studies investigate variations within groups, identification of group differences, simulation of the ontogeny, or association with specific organs or genetic disorders, and GM can be applied to these purposes using multivariate statistical methods. The calculation of high-dimensional data is usually required and has prevented GM from becoming a major morphometric method. However, recent developments in computer technology and software have enabled us to perform it easily with ordinary home computers, and the number of morphometric studies applying GM for facial congenital anomalies has been increasing recently. In this article, we introduce the concept and application of GM and review previous morphometric studies with GM regarding congenital facial anomalies.

脸是一个小而复杂的三维(3D)结构,由各种骨骼和重要器官组成。这些器官的先天性异常表现为各种畸形;因此,它们的量化一直具有挑战性。线性测量,如地标之间的长度或角度,称为传统形态测量学,通常使用二维图像(如照片或x射线图像)来量化它们的表型。在分析过程中,丢失了几何信息,即每个结构的相对位置。几何形态计量学(GM)使用形状配置,包括解剖标志,可以在整个分析过程中保留几何信息,并有助于可视化结果,与传统方法相比,它具有极大的优势。形态计量学研究调查群体内的变异,群体差异的识别,个体发生的模拟,或与特定器官或遗传疾病的关联,转基因可以通过多变量统计方法应用于这些目的。通常需要计算高维数据,这阻碍了GM成为主要的形态测量方法。然而,最近计算机技术和软件的发展使我们能够用普通的家用电脑轻松地执行它,并且最近将GM应用于面部先天性异常的形态计量学研究的数量也在增加。在本文中,我们介绍了基因改造的概念和应用,并回顾了基因改造在先天性面部畸形方面的形态学研究。
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引用次数: 5
Comparative study on detectability of learning and memory disorder between two water maze tests commonly used in juvenile rat toxicity studies using isoflurane inhaled rat model. 异氟醚吸入大鼠幼年毒性研究中常用的两种水迷宫实验对学习记忆障碍可探测性的比较研究。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-03-06 DOI: 10.1111/cga.12460
Hiroshi Mineshima, Hiroki Kimoto, Masaya Hitomi, Fumika Akizawa, Yui Terayama, Tsuyoshi Yoshikawa

Evaluation of learning and memory is crucial in juvenile animal toxicity studies (JAS) during the development of CNS active drugs, but there are no currently recommended test methods. We compared the ability of the Morris water maze (MWM) and the Biel water maze (BWM) to detect learning and memory disorder (LMD) using rats inhaled isoflurane (IFN). Rats were treated with 1% IFN using inhalation on postnatal day (PND) 7 for 6 h. All rats were subjected to the MWM on PND 33 and the BWM on PND 55/57 (Experiment 1), or the BWM on PND 32/33 and the MWM on PND 54/55 (Experiment 2). On PND 70, the brain was weighed and then neurohistopathology was conducted. There were no IFN-related changes in clinical signs and body weight. In the tests beginning on PND 32/33, the MWM clearly detected IFN-related LMD in both sexes whereas the BWM detected LMD only in males. With an additional benefit of a simpler procedure, the MWM was considered superior to the BMW for JAS. LMD was not detected in both mazes tested from PND 54/55/57, which was considered due to weak effect and/or recovery of brain function with growth. Single IFN inhalation on PND 7 was considered useful as positive control to induce LMD caused by postnatal exposure in rats, but stronger treatment regimens was recommended.

在开发中枢神经系统活性药物的过程中,学习和记忆的评估在幼年动物毒性研究(JAS)中至关重要,但目前没有推荐的测试方法。比较Morris水迷宫(MWM)和Biel水迷宫(BWM)对吸入异氟醚(IFN)大鼠学习记忆障碍(LMD)的检测能力。大鼠于出生后第7天(PND)吸入1% IFN治疗6小时。所有大鼠在PND 33上给予MWM并在PND 55/57上给予BWM(实验1),或在PND 32/33上给予BWM并在PND 54/55上给予MWM(实验2)。在PND 70上称重并进行神经组织病理学检查。临床症状和体重没有ifn相关的变化。在从PND 32/33开始的测试中,MWM在两性中都明显检测到ifn相关的LMD,而BWM仅在男性中检测到LMD。由于程序更简单,MWM被认为优于用于JAS的BMW。在PND 54/55/57测试的两个迷宫中均未检测到LMD,这可能是由于影响较弱和/或脑功能随生长而恢复。PND 7单次吸入IFN被认为是诱导大鼠出生后暴露引起的LMD的阳性对照,但建议使用更强的治疗方案。
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引用次数: 0
The first adult case of cytochrome P450 oxidoreductase deficiency with sufficient semen volume and sperm concentration. 第一例成人细胞色素P450氧化还原酶缺乏伴足精液量和精子浓度。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-03-25 DOI: 10.1111/cga.12464
Takeshi Sato, Tomohiro Ishii, Maki Fukami, Tsutomu Ogata, Tomonobu Hasegawa
Cytochrome P450 oxidoreductase deficiency (PORD) is an autosomal recessive disorder and characterized by variable clinical manifesta-tions, including adrenal insufficiency, undervirilization of an individual with the 46,XY karyotype, and bone deformity, owing to impairment of steroid synthesis and cholesterol metabolism. Regarding androgen production capacity, male patients with PORD develop variable puberty, from delayed to spontaneous puber-tal development. 1 To date, studies on spermatogenesis in PORD are scarce. One adult patient with PORD has been reported to develop azoospermia. 2 Another patient showed compromised spermatogenesis on testicular biopsy. 1 Here, we present the case of an adult PORD patient with sufficient semen volume and sperm concentration. arachnodactyly, joint
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引用次数: 1
Androgen/Wnt/β-catenin signal axis augments cell proliferation of the mouse erectile tissue, corpus cavernosum. 雄激素/Wnt/β-catenin信号轴增强小鼠勃起组织海绵体细胞增殖。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-03-29 DOI: 10.1111/cga.12465
Mizuki Kajimoto, Kentaro Suzuki, Yuko Ueda, Kota Fujimoto, Toru Takeo, Naomi Nakagata, Taiju Hyuga, Kyoichi Isono, Gen Yamada

The murine penile erectile tissues including corpus cavernosum (CC) are composed of blood vessels, smooth muscle, and connective tissue, showing marked sexual differences. It has been known that the androgens are required for sexually dimorphic organogenesis. It is however unknown about the features of androgen signaling during mouse CC development. It is also unclear how androgen-driven downstream factors are involved such processes. In the current study, we analyzed the onset of sexually dimorphic CC formation based on histological analyses, the dynamics of androgen receptor (AR) expression, and regulation of cell proliferation. Of note, we identified Dickkopf-related protein 2 (Dkk2), an inhibitor of β-catenin signaling, was predominantly expressed in female CC compared with male. Furthermore, administration of androgens resulted in activation of β-catenin signaling. We have found the Sox9 gene, one of the essential markers for chondrocyte, was specifically expressed in the developing CC. Hence, we utilized CC-specific, Sox9 CreERT2 , β-catenin conditional mutant mice. Such mutant mice showed defective cell proliferation. Furthermore, introduction of activated form of β-catenin mutation (gain of function mutation for Wnt/β-catenin signaling) in CC induced augmented cell proliferation. Altogether, we revealed androgen-Wnt/β-catenin signal dependent cell proliferation was essential for sexually dimorphic CC formation. These findings open new avenues for understanding developmental mechanisms of androgen-dependent cell proliferation during sexual differentiation.

小鼠阴茎勃起组织包括海绵体(CC),由血管、平滑肌和结缔组织组成,性别差异明显。众所周知,雄激素是两性二形器官发生所必需的。然而,在小鼠CC发育过程中雄激素信号的特征尚不清楚。目前还不清楚雄激素驱动的下游因子是如何参与这一过程的。在本研究中,我们基于组织学分析、雄激素受体(AR)表达的动态和细胞增殖的调节分析了两性二态CC形成的开始。值得注意的是,我们发现dickkopf相关蛋白2 (Dkk2),一种β-catenin信号传导抑制剂,与男性相比,在女性CC中主要表达。此外,雄激素的管理导致β-catenin信号的激活。我们发现Sox9基因是软骨细胞的重要标记之一,在发育中的CC中特异性表达,因此我们使用CC特异性的Sox9 CreERT2 β-catenin条件突变小鼠。这种突变小鼠表现出细胞增殖缺陷。此外,在CC中引入活化形式的β-catenin突变(Wnt/β-catenin信号功能突变的获得)诱导细胞增殖增强。总之,我们发现雄激素- wnt /β-catenin信号依赖性细胞增殖是两性二态CC形成的必要条件。这些发现为理解性分化过程中雄激素依赖性细胞增殖的发育机制开辟了新的途径。
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引用次数: 4
Liver pathological alterations in fetal rabbit model of congenital diaphragmatic hernia. 先天性膈疝胎兔模型肝脏病理改变。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-02-25 DOI: 10.1111/cga.12462
Gloria Pelizzo, José L Peiro, Vincenzo Villanacci, Laurenço Sbragia, Marc Oria, Annalisa De Silvestri, Emanuela Mazzon, Valeria Calcaterra

To date, fetal liver implication is not a well-understood phenomenon in congenital diaphragmatic hernia (CDH). We evaluated the fetal morphologic changes on liver growth after surgical procedure in CDH experimental model. A diaphragmatic defect at gestational day E25 and tracheal occlusion (TO) at E27 were surgically created in rabbit fetuses. Five experimental groups were assessed: control group, left CDH, right CDH, CDH + TO, and TO alone. Body and organ growth were measured. For histological evaluation of the CDH effect, liver sections were collected. Left-CDH group had livers with increased leukocyte infiltration in comparison with controls (p = 0.02). Increased capillary sinusoid congestion and hepatocyte vacuolation were greater in left-CDH compared with the right-CDH group (p = 0.05). Capillary sinusoid congestion and interstitial edema were more evident in the left-CDH compared with CDH + TO group (p = 0.05). Increases in sinusoid congestion, hepatocyte vacuolation, and interstitial edema were also greater in the CDH + TO compared with controls (p ≤ 0.02). Intrathoracic liver weight was higher in right-CDH compared with left-CDH group (p < 0.001). Total lung weights (TLW) were significantly lower in both left-CDH compared with controls (p < 0.001), CDH + TO (p = 0.01), and TO (p < 0.01) and in right-CDH compared with CDH + TO (p < 0.01) and TO (p < 0.01). Decreased kidney and heart weights were also recorded. Hemodynamics and structural fetal liver changes in laterality were noted in CDH model. Regulation of intrathoracic liver weights seems to be disturbed by the absence of diaphragmic contact. Pulmonary injury is supported by the effect of a first hit, while the growth of internal organs suggests a multisystemic remodeling related to the fetal adaptation.

到目前为止,胎儿肝脏的影响并不是一个很好的理解先天性膈疝(CDH)的现象。我们在CDH实验模型中评估手术后胎儿肝脏生长的形态学变化。在妊娠期E25时手术产生膈缺损,在妊娠期E27时手术产生气管闭塞(TO)。分为5个实验组:对照组、左CDH组、右CDH组、CDH + TO组和单独使用TO组。测量身体和器官的生长情况。为了对CDH效应进行组织学评价,收集肝脏切片。左- cdh组肝脏白细胞浸润较对照组增加(p = 0.02)。与右cdh组相比,左cdh组毛细血管窦充血和肝细胞空泡增多(p = 0.05)。与CDH + TO组相比,左CDH组毛细血管窦充血和间质水肿更为明显(p = 0.05)。与对照组相比,CDH + TO组鼻窦充血、肝细胞空泡和间质水肿的增加也更大(p≤0.02)。右cdh组胸内肝重量高于左cdh组(p
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引用次数: 3
A systematic review of maternal diabetes and congenital skeletal malformation. 母体糖尿病与先天性骨骼畸形的系统综述。
IF 1.3 4区 医学 Pub Date : 2022-05-01 Epub Date: 2022-03-30 DOI: 10.1111/cga.12463
Krupa Shah, Hitesh Shah

The magnitude of association of skeletal anomalies with maternal diabetes is not known. The systemic review was done to detect the frequency of congenital skeletal malformations with diabetes mellitus in pregnancy in the literature evidence of the past 50 years. Literature on maternal diabetes and skeletal malformation was searched by two independent authors by following PRISMA guidelines. Strict inclusion and exclusion criteria were followed. After quality assessment, 21 original articles were included. The frequency of congenital malformation, skeletal malformation was extracted from the included studies. 11,574 congenital anomalies were detected diabetic mothers. 1182 skeletal anomalies were noted in 20,11 552 diabetic mothers. The skeletal malformation was noted in 20.4% of total anomalies. The most common skeletal malformation was the defect of the spine (39.9%). The limb deficiency was found in 32.8% of the infants of diabetic mothers. The skeletal malformations were higher, that is, 24.6% in pre-gestational diabetes. The incidence of skeletal malformation from the evidence was 1.5% (range: 0.03-4.27%) in maternal diabetes. Pre-gestation diabetes is more frequently associated with skeletal malformations, which is 1.9% (range: 0.07-5.89%). The association of congenital malformations and skeletal malformations in diabetic pregnancy is significant and hence, effective management of diabetes in childbearing age is essential to reduce this incidence and related long-term morbidity.

骨骼异常与母体糖尿病的关联程度尚不清楚。本文对近50年来妊娠期糖尿病合并先天性骨骼畸形的文献资料进行了系统的回顾性分析。两位独立作者按照PRISMA指南检索了关于产妇糖尿病和骨骼畸形的文献。遵循严格的纳入和排除标准。经质量评估,纳入21篇原创文章。从纳入的研究中提取先天性畸形、骨骼畸形的发生率。诊断出11,574例先天性异常的糖尿病母亲。20,11,552例糖尿病母亲中发现1182例骨骼异常。骨骼畸形占全部异常的20.4%。最常见的骨骼畸形是脊柱缺损(39.9%)。患糖尿病母亲所生的婴儿中有32.8%存在肢体缺陷。妊娠前期糖尿病患者骨骼畸形发生率较高,为24.6%。从证据来看,产妇糖尿病中骨骼畸形的发生率为1.5%(范围:0.03-4.27%)。妊娠前糖尿病更常与骨骼畸形相关,占1.9%(范围:0.07-5.89%)。糖尿病妊娠中先天性畸形和骨骼畸形的关联是显著的,因此,育龄期糖尿病的有效管理对于减少这种发病率和相关的长期发病率至关重要。
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引用次数: 0
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Congenital Anomalies
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