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Correlation between COVID-19 infection and fetal situs inversus COVID-19感染与胎位不正之间的相关性。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-03-05 DOI: 10.1002/bdr2.2324
Shuo Qiu, Shuang Wu, Ranran Yin, Bo Wang, Hongying Wu

Background

Situs inversus is a rare congenital condition, defined by the mirror-image transposition of the abdominothoracic organs. It is linked to an increased risk of different disorders, for example, congenital heart defects and primary ciliary dyskinesia. Recently, some reports have been on the increased incidence of situs inversus after the COVID-19 pandemic.

Objectives

To investigate the association between maternal COVID-19 infection and fetal situs inversus occurrence risk.

Methods

All pregnant women who underwent fetal ultrasound examinations at Jinan Maternal and Child Health Hospital from January to May of 2022 and 2023 were recruited. A chi-square test was conducted to assess the association of maternal COVID-19 infection with the incidence rate of fetal situs inversus.

Results

A total of 8381 patients, including 25 with situs inversus fetuses were recruited. A total of 3956 patients had COVID-19, while 4400 did not. Among 25 mothers with situs inversus fetuses, 22 had COVID-19 and 3 without recent infection. Our analysis showed a strong link between COVID-19 and a higher risk of fetus situs inversus (P < .001, odds ratio 8.196).

Conclusion

Maternal COVID-19 infection in the early stages of the pregnancy is associated with an increased risk of fetal situs inversion occurrence. Therefore, further research in this field seems necessary.

背景:腹腔内翻位是一种罕见的先天性疾病,是指腹腔和胸腔器官的镜像转位。它与罹患各种疾病的风险增加有关,例如先天性心脏缺陷和原发性睫状肌运动障碍。最近,有报道称 COVID-19 大流行后,坐位倒置的发病率有所增加:研究母体感染 COVID-19 与胎儿发生坐位不正风险之间的关系:方法:招募2022年和2023年1月至5月在济南市妇幼保健院接受胎儿超声检查的所有孕妇。采用卡方检验评估母体COVID-19感染与胎儿坐位不正发生率的相关性:结果:共招募了 8381 名患者,其中包括 25 名坐位倒置胎儿患者。共有 3956 名患者感染了 COVID-19,4400 名患者未感染。在 25 位患有坐位难产的母亲中,22 位患有 COVID-19,3 位近期未感染。我们的分析表明,COVID-19 与胎儿发生坐位不正的较高风险之间存在密切联系(P 结论:COVID-19 与胎儿发生坐位不正的较高风险之间存在密切联系:孕早期母体感染 COVID-19 与胎儿发生坐位倒置的风险增加有关。因此,有必要在这一领域开展进一步研究。
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引用次数: 0
Gastroschisis prevalence patterns in 27 surveillance programs from 24 countries, International Clearinghouse for Birth Defects Surveillance and Research, 1980–2017 国际出生缺陷监测和研究信息交流中心,1980-2017 年 24 个国家 27 个监测项目中的胃畸形流行模式。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-27 DOI: 10.1002/bdr2.2306
Marcia L. Feldkamp, Mark A. Canfield, Sergey Krikov, David Prieto-Merino, Antonin Šípek Jr, Nathalie LeLong, Emmanuelle Amar, Anke Rissmann, Melinda Csaky-Szunyogh, Giovanna Tagliabue, Anna Pierini, Miriam Gatt, Jorieke E. H. Bergman, Elena Szabova, Eva Bermejo-Sánchez, David Tucker, Saeed Dastgiri, María Paz Bidondo, Aurora Canessa, Ignacio Zarante, Paula Hurtado-Villa, Laura Martinez, Osvaldo M. Mutchinick, Jorge Lopez Camelo, Adriana Benavides-Lara, Mary Ann Thomas, Shiliang Liu, Wendy N. Nembhard, Elizabeth B. Gray, Amy E. Nance, Pierpaolo Mastroiacovo, Lorenzo D. Botto

Background

Gastroschisis is a serious birth defect with midgut prolapse into the amniotic cavity. The objectives of this study were to evaluate the prevalence and time trends of gastroschisis among programs in the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR), focusing on regional variations and maternal age changes in the population.

Methods

We analyzed data on births from 1980 to 2017 from 27 ICBDSR member programs, representing 24 countries and three regions (Europe+ (includes Iran), Latin America, North America). Cases were identified using diagnostic codes (i.e., 756.7, 756.71, or Q79.3). We excluded cases of amniotic band syndrome, limb–body wall defect, and ruptured omphalocele. Programs provided annual counts for gastroschisis cases (live births, stillbirths, and legally permitted pregnancy terminations for fetal anomalies) and source population (live births, stillbirths), by maternal age.

Results

Overall, gastroschisis occurred in 1 of every 3268 births (3.06 per 10,000 births; 95% confidence intervals [CI]: 3.01, 3.11), with marked regional variation. European+ prevalence was 1.49 (95%CI: 1.44, 1.55), Latin American 3.80 (95%CI: 3.69, 3.92) and North American 4.32 (95%CI: 4.22, 4.42). A statistically significant increasing time trend was observed among six European+, four Latin American, and four North American programs. Women <20 years of age had the highest prevalence in all programs except the Slovak Republic.

Conclusions

Gastroschisis prevalence increased over time in 61% of participating programs, and the highest increase in prevalence was observed among the youngest women. Additional inquiry will help to assess the impact of the changing maternal age proportions in the birth population on gastroschisis prevalence.

背景:胃畸形是一种严重的出生缺陷,会导致中肠脱垂进入羊膜腔。本研究的目的是评估国际出生缺陷监测和研究信息交换中心(ICBDSR)各项目中胃螺裂的患病率和时间趋势,重点关注地区差异和人群中产妇年龄的变化:我们分析了来自 27 个 ICBDSR 成员项目(代表 24 个国家和 3 个地区(欧洲+(包括伊朗)、拉丁美洲和北美洲))的 1980 年至 2017 年的出生数据。病例使用诊断代码(即 756.7、756.71 或 Q79.3)进行鉴定。我们排除了羊膜带综合征、肢体-体壁缺损和脐膨出的病例。各项目提供了按产妇年龄分列的胃畸形病例(活产、死胎和因胎儿畸形而合法终止妊娠)和来源人群(活产、死胎)的年度计数:总体而言,每 3268 例新生儿中就有 1 例患有胃畸形(每 10,000 例新生儿中有 3.06 例患有胃畸形;95% 置信区间 [CI]:3.01, 3.11),地区差异明显。欧洲+的发病率为 1.49(95% 置信区间:1.44,1.55),拉丁美洲为 3.80(95% 置信区间:3.69,3.92),北美为 4.32(95% 置信区间:4.22,4.42)。在 6 个欧洲+、4 个拉丁美洲和 4 个北美项目中,观察到了统计学上明显的时间增长趋势。女性 结论:在 61% 的参与项目中,胃畸形发病率随着时间的推移而增加,在最年轻的女性中观察到的发病率增幅最大。更多的调查将有助于评估出生人口中产妇年龄比例的变化对胃螺裂发生率的影响。
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引用次数: 0
Updated EUROCAT guidelines for classification of cases with congenital anomalies 更新的 EUROCAT 先天性畸形病例分类指南。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-16 DOI: 10.1002/bdr2.2314
Jorieke E. H. Bergman, Annie Perraud, Ingeborg Barišić, Agnieszka Kinsner-Ovaskainen, Joan K. Morris, David Tucker, Diana Wellesley, Ester Garne

Background

Precise and correct classification of congenital anomalies is important in epidemiological studies, not only to classify according to etiology but also to group similar congenital anomalies together, to create homogeneous subgroups for surveillance and research. This paper presents the updated EUROCAT (European surveillance of congenital anomalies) subgroups of congenital anomalies and the updated multiple congenital anomaly (MCA) algorithm and provides the underlying arguments for the revisions.

Methods

The EUROCAT methodology is described. In addition, we show how we validated the revised EUROCAT subgroups and MCA algorithm, which are both based on the International Classification of Diseases (ICD10/ICD9) codes.

Results

The updated EUROCAT subgroups and the updated MCA algorithm are described in detail and the updated version is compared to the previous versions.

Conclusion

The EUROCAT subgroups and MCA algorithm provide a standardized and clear methodology for congenital anomaly research and epidemiological surveillance of congenital anomalies in order to facilitate the identification of teratogenic exposures and to assess the impact of primary prevention and prenatal screening policies. The EUROCAT subgroups and MCA algorithm are made freely available for other researchers via the EUROCAT Database Management Software.

背景:在流行病学研究中,对先天性畸形进行精确和正确的分类非常重要,这不仅是为了根据病因进行分类,也是为了将类似的先天性畸形归为一类,为监测和研究创建同质亚组。本文介绍了更新后的EUROCAT(欧洲先天性异常监测)先天性异常分组和更新后的多发性先天性异常(MCA)算法,并提供了修订的基本论据:方法:介绍了 EUROCAT 方法。此外,我们还展示了如何验证修订后的EUROCAT亚组和MCA算法,它们均基于国际疾病分类(ICD10/ICD9)代码:结果:详细介绍了更新后的EUROCAT亚组和MCA算法,并将更新后的版本与之前的版本进行了比较:结论:EUROCAT 亚组和 MCA 算法为先天性异常研究和先天性异常流行病学监测提供了标准化和明确的方法,以促进致畸暴露的识别,并评估一级预防和产前筛查政策的影响。EUROCAT分组和MCA算法可通过EUROCAT数据库管理软件免费提供给其他研究人员。
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引用次数: 0
Arginase 1 does not affect RNA m6A methylation in mouse fetal lung 精氨酸酶 1 不会影响小鼠胎肺中 RNA m6A 的甲基化。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-16 DOI: 10.1002/bdr2.2318
Xuesong Sui, Yanyu Sui, Peihua Long, Yifei Wang, Yu Chen, Wenjia Zhai, Lu Gao

Background

Arginase 1 (Arg1) encodes a key enzyme that catalyzes the metabolism of arginine to ornithine and urea. In our recent study, we found that knockdown of Arg1 in the lungs of fetal mice induces apoptosis of epithelial cells and dramatically delays initiation of labor. As the most abundant internal mRNA modification, N6-methyladenosine (m6A) has been found to play important roles in lung development and cellular differentiation. However, if the knockdown of Arg1 affects the RNA m6A modification in fetal lungs remains unknown.

Methods

In the current study, the RNA m6A levels and the expression of RNA m6A related enzymes were validated in 13.0 dpc fetal lungs that Arg1 was knocked down by adeno-associated virus carrying Arg1-shRNA, using western blot, immunofluorescence, and RT-qPCR.

Results

No statistical differences were found in the expression of methyltransferase, demethylases, and binding proteins in the fetal lungs between AAV-shArg1-injected mice and AAV-2/9-injected mice. Besides, there is no significant change of overall RNA m6A level in fetal lungs from AAV-shArg1-injected mice, compared with that from AAV-2/9-injected mice.

Conclusions

These results indicate that arginase 1 does not affect RNA m6A methylation in mouse fetal lung, and the mechanisms other than RNA m6A modification underlying the effects of Arg1 knockdown on the fetal lung development and their interaction with labor initiation need to be further explored.

背景:精氨酸酶 1(Arg1)编码一种催化精氨酸代谢为鸟氨酸和尿素的关键酶。在我们最近的研究中,我们发现敲除胎儿小鼠肺中的 Arg1 会诱导上皮细胞凋亡,并显著推迟分娩的开始。N6 -甲基腺苷(m6 A)作为最丰富的内部 mRNA 修饰,已被发现在肺发育和细胞分化中发挥重要作用。然而,敲除 Arg1 是否会影响胎儿肺部的 RNA m6A 修饰仍是未知数:方法:本研究采用免疫印迹、免疫荧光和 RT-qPCR 等方法,验证了通过携带 Arg1-shRNA 的腺相关病毒敲除 Arg1 的 13.0 dpc 胎肺中 RNA m6A 水平和 RNA m6A 相关酶的表达:结果:AAV-shArg1注射小鼠与AAV-2/9注射小鼠胎肺中甲基转移酶、去甲基化酶和结合蛋白的表达无统计学差异。此外,与注射AAV-2/9的小鼠相比,注射AAV-shArg1的小鼠胎肺中总体RNA m6A水平没有明显变化:这些结果表明,精氨酸酶1并不影响小鼠胎肺中RNA m6A的甲基化,除RNA m6A修饰外,敲除Arg1对胎肺发育的影响及其与分娩启动的相互作用机制还有待进一步探讨。
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引用次数: 0
Monochorionic triplet pregnancy complicated by conjoined twins and early twin–twin transfusion syndrome 单绒毛膜三胞胎妊娠并发连体双胞胎和早期双胞胎输血综合征。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-16 DOI: 10.1002/bdr2.2317
Juan Carlos Bustos, Helga Vera, Paz Ahumada, Daniel Martin

Background

The condition of monozygotic, monochorionic triplet fetuses with a pair of conjoined twins is extremely rare (close to one in a million births), presents challenges in its management, and with poor prognosis.

Case report

We report a case of monochorionic diamniotic triplet pregnancy, ultrasound at 14 weeks shows a pair of conjoined thoracopagus fetuses, sharing heart, liver, and umbilical cord, in addition to omphalocele. The third fetus, without malformations, presents signs of early heart failure compatible with twin-to-twin transfusion syndrome. It was decided to carry out expectant management where at 18 weeks, intrauterine death of the three fetuses occurs. An abortion is performed by hysterotomy.

Conclusions

The treatment in these cases is discussed, three management options have been proposed: expectant management, selective reduction of the conjoined fetuses, or termination of the pregnancy. A review of the literature found only 12 cases with this combination of pathologies, in which only 3 normal fetuses (25%) survived and none of the conjoined twins survived. To our knowledge, this case is the first of a monochorionic triplet pregnancy with conjoined fetuses complicated with early twin-to-twin transfusion.

背景:单卵双胎、单绒毛膜三胞胎和一对连体婴儿的情况极为罕见(接近百万分之一),其管理面临挑战,且预后较差:我们报告了一例单绒毛膜双羊膜腔三胎妊娠,14 周时的超声检查显示一对连体胸腔畸形胎儿,共用心脏、肝脏和脐带,此外还有脐膨出。第三个胎儿没有畸形,但出现了早期心衰的迹象,与双胎输血综合征相符。在 18 周时,三个胎儿在宫内死亡。结论:讨论了这些病例的治疗方法:对这些病例的治疗方法进行了讨论,提出了三种处理方案:期待处理、选择性减少连体胎儿或终止妊娠。查阅文献后发现,只有 12 例合并这种病变的病例,其中只有 3 个正常胎儿(25%)存活,连体婴儿无一存活。据我们所知,本病例是首例单绒毛膜三胞胎妊娠合并连体胎儿早期双胎输血的病例。
{"title":"Monochorionic triplet pregnancy complicated by conjoined twins and early twin–twin transfusion syndrome","authors":"Juan Carlos Bustos,&nbsp;Helga Vera,&nbsp;Paz Ahumada,&nbsp;Daniel Martin","doi":"10.1002/bdr2.2317","DOIUrl":"10.1002/bdr2.2317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The condition of monozygotic, monochorionic triplet fetuses with a pair of conjoined twins is extremely rare (close to one in a million births), presents challenges in its management, and with poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case report</h3>\u0000 \u0000 <p>We report a case of monochorionic diamniotic triplet pregnancy, ultrasound at 14 weeks shows a pair of conjoined thoracopagus fetuses, sharing heart, liver, and umbilical cord, in addition to omphalocele. The third fetus, without malformations, presents signs of early heart failure compatible with twin-to-twin transfusion syndrome. It was decided to carry out expectant management where at 18 weeks, intrauterine death of the three fetuses occurs. An abortion is performed by hysterotomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The treatment in these cases is discussed, three management options have been proposed: expectant management, selective reduction of the conjoined fetuses, or termination of the pregnancy. A review of the literature found only 12 cases with this combination of pathologies, in which only 3 normal fetuses (25%) survived and none of the conjoined twins survived. To our knowledge, this case is the first of a monochorionic triplet pregnancy with conjoined fetuses complicated with early twin-to-twin transfusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9121,"journal":{"name":"Birth Defects Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selenium mitigates methotrexate-induced testicular injury: Insights from male NMRI mice model 硒可减轻甲氨蝶呤引起的睾丸损伤:雄性 NMRI 小鼠模型的启示。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-13 DOI: 10.1002/bdr2.2315
Mohammadreza Gholami, Afsaneh Nemati, Azita Alasvand Zarasvand, Abolfazl Zendehdel, Cyrus Jalili, Iraj Rashidi, Kamran Mansouri, Forough Taheri, Vahideh Assadollahi, Elham Gholami

Background and Aim

Chemotherapy, particularly with methotrexate (MTX), often elicits testicular toxicity, leading to impaired spermatogenesis and hormone imbalances. This study aimed to investigate the potential protective effects of selenium (Se) against MTX-induced testicular injury.

Materials and Methods

Male mice were divided into control, MTX, Se, and MTX + Se groups. Histopathological examination involved the preparation of testicular tissue sections using the Johnsen's tubular biopsy score (JTBS) for spermatogenesis evaluation. Biochemical tests included the assessment of testosterone, malondialdehyde (MDA), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels. Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to analyze the expression of caspase 3 (casp3), tumor protein 53 (p53), B-cell lymphoma 2 (Bcl2), and Bcl2-associated X protein (Bax) genes. Statistical analysis was performed using ANOVA and Tukey's tests (p < .05).

Results

Histopathological analysis revealed significant testicular damage in the MTX group, with decreased spermatogenesis and Leydig cell count, while Se administration mitigated these effects, preserving the structural integrity of the reproductive epithelium. Biochemical analysis demonstrated that MTX led to elevated malondialdehyde (MDA) levels and reduced testosterone, LH, and FSH levels, suggesting oxidative stress and Leydig cell dysfunction. Gene expression analysis indicated that MTX upregulated proapoptotic genes (casp3, p53, and bax) while downregulating the antiapoptotic Bcl2 gene. In contrast, Se treatment reversed these trends, highlighting its potential antiapoptotic properties.

Conclusion

Our findings underscore the potential of Se as a therapeutic agent to mitigate the reproductive toxicity associated with MTX-induced testicular injury. Se exerts protective effects by regulating oxidative stress, preserving hormone balance, and modulating apoptotic pathways. These results suggest that Se supplementation could be a promising strategy to alleviate chemotherapy-induced testicular damage and preserve male fertility.

背景和目的:化疗,尤其是甲氨蝶呤(MTX),经常引起睾丸毒性,导致精子发生障碍和激素失衡。本研究旨在探讨硒(Se)对 MTX 引起的睾丸损伤的潜在保护作用:雄性小鼠分为对照组、MTX 组、Se 组和 MTX + Se 组。组织病理学检查包括使用约翰森小管活检评分法(JTBS)制备睾丸组织切片,以评估精子发生情况。生化检验包括评估睾酮、丙二醛(MDA)、黄体生成素(LH)和促卵泡激素(FSH)水平。采用实时定量聚合酶链反应(RT-qPCR)分析了caspase 3(casp3)、肿瘤蛋白53(p53)、B细胞淋巴瘤2(Bcl2)和Bcl2相关X蛋白(Bax)基因的表达。统计分析采用方差分析和 Tukey 检验(P 结果):组织病理学分析表明,MTX 组睾丸明显受损,精子发生和雷迪格细胞数量减少,而 Se 组则减轻了这些影响,保持了生殖上皮细胞结构的完整性。生化分析表明,MTX导致丙二醛(MDA)水平升高,睾酮、LH和FSH水平降低,表明存在氧化应激和Leydig细胞功能障碍。基因表达分析表明,MTX 上调了促凋亡基因(casp3、p53 和 bax),同时下调了抗凋亡基因 Bcl2。与此相反,Se 治疗逆转了这些趋势,凸显了其潜在的抗凋亡特性:我们的研究结果强调了Se作为一种治疗剂,减轻MTX诱导的睾丸损伤相关生殖毒性的潜力。Se 可通过调节氧化应激、保持激素平衡和调节细胞凋亡途径发挥保护作用。这些结果表明,补充Se可能是减轻化疗引起的睾丸损伤和保护男性生育能力的一种有前途的策略。
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引用次数: 0
Prevalence of craniosynostosis in Finland, 1987–2010: A population-based study 1987-2010年芬兰颅畸形发病率:一项基于人口的研究。
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-13 DOI: 10.1002/bdr2.2319
Pia Vuola, Niklas Pakkasjärvi, Annukka Ritvanen, Arja Heliövaara, Erkki Tukiainen, Mika Gissler

Background

Craniosynostosis is a prevalent craniofacial malformation in Finland; however, comprehensive population-based epidemiological data are limited. This study aimed to estimate the total and birth prevalence of craniosynostosis in Finland from 1987 to 2010 and examine temporal trends.

Methods

We collected the data from nationwide registers maintained by the Finnish Institute for Health and Welfare and Statistics Finland, as well as treating hospitals, encompassing live births, stillbirths, terminations for fetal anomalies, and infant deaths with suspected or diagnosed craniosynostosis or skull deformation. A craniofacial surgeon and a clinical geneticist reviewed 1878 medical records for diagnostic confirmation.

Results

Out of 877 craniosynostosis cases, 83% were single-suture synostoses (all live births), 10% craniosynostosis syndromes, and 7% multisutural non-syndromic synostoses. Live birth prevalence from 1987 to 2010 was 6.0/10,000 live births, ranging from 5.0/10,000 in 1987 to 7.5/10,000 in 2010. Total prevalence, including live births, stillbirths, and terminations, varied from 5.0/10,000 in 1987 to 8.0/10,000 in 2010. Sagittal synostosis was the most common synostosis, with a prevalence of 3.9/10,000 live births, followed by metopic (0.6/10,000), unicoronal (0.4/10,000), and unilambdoid (0.1/10,000) synostoses.

Conclusions

The total combined prevalence of all craniosynostosis types significantly increased driven by a nonsignificant rise across all subgroups and a significant increase in the syndrome group. In live births increase was significant only within the syndrome subgroup, primarily due to an increase in Muenke syndrome patients. The rising prevalence of syndromes necessitates further investigation. Contrasting with trends in Europe, Australia, and the USA, Finland showed no significant increase in metopic craniosynostosis.

背景:在芬兰,颅畸形是一种常见的颅面畸形;然而,基于人口的综合流行病学数据却很有限。本研究旨在估算1987年至2010年芬兰颅畸形的总患病率和出生患病率,并研究其时间趋势:我们从芬兰卫生与福利研究所(Finnish Institute for Health and Welfare)和芬兰统计局(Statistics Finland)保存的全国登记册以及治疗医院收集数据,包括活产、死产、胎儿畸形终止妊娠以及疑似或诊断为颅骨发育不良或颅骨畸形的婴儿死亡。一名颅面外科医生和一名临床遗传学家审查了 1878 份病历,以进行诊断确认:结果:在 877 例颅突症病例中,83% 为单缝合颅突症(均为活产),10% 为颅突症综合征,7% 为多缝合颅突症(非综合征)。1987年至2010年的活产患病率为6.0/10,000,1987年为5.0/10,000,2010年为7.5/10,000。包括活产、死产和终止妊娠在内的总患病率从1987年的5.0/10,000到2010年的8.0/10,000不等。矢状突胸是最常见的突胸,发病率为 3.9/10,000,其次是偏侧突胸(0.6/10,000)、单冠突胸(0.4/10,000)和单斜突胸(0.1/10,000):结论:所有颅突症类型的总合患病率显著增加,所有亚组的患病率均无显著增加,而综合征组的患病率显著增加。只有在综合征亚组中,活产婴儿的发病率才有显著增长,这主要是由于穆恩科综合征患者的增加。综合症发病率的上升需要进一步调查。与欧洲、澳大利亚和美国的趋势不同,芬兰的偏头颅畸形没有明显增加。
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引用次数: 0
Climate and environmental changes exacerbate health disparities in pregnant people and their offspring. How can we protect women and their babies? 气候和环境变化加剧了孕妇及其后代的健康差异。我们该如何保护妇女及其婴儿?
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-13 DOI: 10.1002/bdr2.2313
Guillermina Girardi, Andrew A. Bremer

Background

The effects of climate and environmental changes (CEC) are being felt globally and will worsen over the next decade unless significant changes are made on a global level. Climate change is having serious consequences for health, particularly for vulnerable women and their offspring and less resilient individuals in communities with socioeconomic inequalities. To protect human health from CEC effects, efforts need to be directed toward building resilience strategies. Building political and economic power, as well as directly addressing CEC-related challenges, are critical components of climate resilience. Effective communication and tailored methods to engage women in preventive strategies are also necessary to ameliorate the deleterious effects of CEC on women's health. Furthermore, women from marginalized communities face more CEC-associated challenges.

Conclusions

Therefore, effective policies and programs targeting these at-risk populations—are crucial to improve the overall state of global health. In closing, it is time to increase awareness of the effects of CECs on women's health and their transgenerational effects in order to ensure that all people, regardless of race, ethnicity, education and income are protected from the detrimental effects of CECs.

背景:全球都能感受到气候和环境变化(CEC)的影响,除非在全球范围内做出重大改变,否则这种影响将在未来十年内加剧。气候变化正在对健康造成严重后果,尤其是对弱势妇女及其后代,以及社会经济不平等社区中抗灾能力较弱的个人。为了保护人类健康免受气候变化的影响,需要努力制定抗灾战略。建立政治和经济力量以及直接应对与《气候公约》相关的挑战,是气候复原力的关键组成部分。有效的沟通和量身定制的方法让妇女参与预防性战略也是改善《气候公约》对妇女健康的有害影响所必需的。此外,来自边缘化社区的妇女面临着更多与气候变化相关的挑战:因此,针对这些高危人群的有效政策和计划对于改善全球整体健康状况至关重要。最后,现在是时候提高人们对 CEC 对妇女健康的影响及其跨代影响的认识了,以确保所有人,无论种族、民族、教育程度和收入如何,都能免受 CEC 的有害影响。
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引用次数: 0
A case-control study characterizing polydactyly risk factors in Bogotá and Cali, Colombia between 2002 and 2020 2002 至 2020 年哥伦比亚波哥大和卡利多指畸形风险因素的病例对照研究
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-11 DOI: 10.1002/bdr2.2312
Esteban Portilla-Rojas, Lina Ramírez, Camilo Moreno, Juliana Lores, Karen Sarmiento, Ignacio Zarante

Background

Polydactyly is a congenital abnormality characterized by the presence of additional fingers on one or more extremities. In Colombia, polydactyly accounted for 17% of musculoskeletal congenital abnormalities in 2021, with a prevalence of 6.03 per 10,000 live births. The purpose of this study was to determine the prevalence of polydactyly and identify associated risk factors in Bogotá and Cali, Colombia, from 2002 to 2020.

Methods

A retrospective case-control study design was employed, analyzing data from birth defect reports provided by the Program for the Prevention and Follow-up of Congenital Defects and Orphan Diseases surveillance system. Cases included live births or stillbirths with polydactyly, while controls consisted of infants without congenital abnormality, matched in terms of birth date and hospital. Prevalence of polydactyly was calculated and risk factors were assessed through odds ratios obtained by logistic regression models, considering a 95% confidence interval.

Results

Among the 558,255 births included in the study, 848 cases of polydactyly were identified, resulting in a prevalence rate of 15.19 per 10,000 live births. Risk factors associated with polydactyly included male newborn sex, pregestational diabetes, and a family history of malformation among first-degree relatives.

Conclusion

These findings highlight the importance a surveillance system aimed to characterize populations with congenital abnormalities, providing a better option for analyzing risk factors, help improving prevention, diagnosis, notification, and optimal treatment in patients.

背景多指畸形是一种先天性畸形,其特征是一个或多个肢体上有额外的手指。在哥伦比亚,多指畸形占 2021 年肌肉骨骼先天畸形的 17%,发病率为每 10,000 名活产婴儿中有 6.03 例。本研究旨在确定 2002 年至 2020 年哥伦比亚波哥大和卡利地区多指畸形的发病率,并识别相关风险因素。 方法 采用回顾性病例对照研究设计,分析先天性缺陷和孤儿疾病预防和跟踪计划监控系统提供的出生缺陷报告数据。病例包括患有多指畸形的活产或死产婴儿,而对照组则包括无先天性异常的婴儿,出生日期和医院均匹配。计算多指畸形的患病率,并通过逻辑回归模型得出的几率比(考虑 95% 的置信区间)评估风险因素。 结果 在纳入研究的 558 255 名新生儿中,发现了 848 例多指畸形,患病率为每万名活产婴儿 15.19 例。多指畸形的相关风险因素包括新生儿性别为男性、孕前糖尿病以及一级亲属中有畸形家族史。 结论 这些发现凸显了监测系统的重要性,该系统旨在描述先天性畸形人群的特征,为分析风险因素提供更好的选择,有助于改善预防、诊断、通知和对患者的最佳治疗。
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引用次数: 0
HESI workshop summary: Interpretation of developmental and reproductive toxicity endpoints and the impact on data interpretation of adverse events HESI 研讨会摘要:发育和生殖毒性终点的解释及对不良事件数据解释的影响
IF 2.1 4区 医学 Q1 Medicine Pub Date : 2024-02-11 DOI: 10.1002/bdr2.2311
M. L. Green, A. Kluever, Connie Chen, S. Dobreniecki, Wendy Halpern, Bethany Hannas, Alan Hoberman, M. E. McNerney, S. Mitchell-Ryan, T. J. Shafer, Steven Van Cruchten, Tacey White

The Health and Environmental Sciences Institute Developmental and Reproductive Toxicology (HESI-DART) group held a hybrid in-person and virtual workshop in Washington, DC, in 2022. The workshop was entitled, “Interpretation of DART in Regulatory Contexts and Frameworks.” There were 154 participants (37 in person and 117 virtual) across 9 countries. The purpose of the workshop was to capture key consensus approaches used to assess DART risks associated with chemical product exposure when a nonclinical finding is identified. The decision-making process for determining whether a DART endpoint is considered adverse is critical because the outcome may have downstream implications (e.g., increased animal usage, modifications to reproductive classification and pregnancy labeling, impact on enrollment in clinical trials and value chains). The workshop included a series of webinar modules to train and engage in discussions with federal and international regulators, clinicians, academic investigators, nongovernmental organizations, contract research organization scientists, and private sector scientists on the best practices and principles of interpreting DART and new approach methodologies in the context of regulatory requirements and processes. Despite the differences in regulatory frameworks between the chemical and pharmaceutical sectors, the same foundational principles for data interpretation should be applied. The discussions led to the categorization of principles, which offer guidance for the systematic interpretation of data. Step 1 entails identifying any hazard by closely analyzing the data at the study endpoint level, while Step 2 involves assessing risk using weight of evidence. These guiding principles were derived from the collective outcomes of the workshop deliberations.

2022 年,健康与环境科学研究所发育与生殖毒理学(HESI-DART)小组在华盛顿特区举办了一次现场与虚拟混合研讨会。研讨会的主题是 "监管背景和框架下的 DART 解释"。来自 9 个国家的 154 名与会者(37 名亲临现场,117 名虚拟与会者)参加了此次研讨会。研讨会的目的是收集关键的共识方法,用于在发现非临床发现时评估与化学产品暴露相关的 DART 风险。确定 DART 终点是否被视为不利因素的决策过程至关重要,因为其结果可能会产生下游影响(例如,增加动物用量、修改生殖分类和妊娠标签、影响临床试验和价值链的注册)。研讨会包括一系列网络研讨会模块,对联邦和国际监管机构、临床医生、学术研究人员、非政府组织、合同研究组织科学家和私营部门科学家进行培训,并与他们讨论在监管要求和流程背景下解释 DART 和新方法学的最佳实践和原则。尽管化学和制药部门的监管框架不同,但数据解读的基本原则应该相同。通过讨论,对原则进行了分类,为系统解释数据提供了指导。第 1 步需要通过仔细分析研究终点层面的数据来确定任何危害,而第 2 步则涉及使用证据权重来评估风险。这些指导原则源自研讨会的集体讨论结果。
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引用次数: 0
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Birth Defects Research
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