Risk factors for congenital anomalies in high risk pregnant women: A large study from South India

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• 作者：Tella Sunitha^a ; Kattekola Rebekah Prasoona^a ; Tiruvatturu Muni Kumari^b ; Buragadda Srinadh^a ; Madireddy Laxmi Naga Deepika^a ; Ramaiah Aruna^b ; Akka Jyothy^a ; ^{jyothycell@rediffmail.com}
• 关键词：HRP ; High Risk Pregnancy ; CAs ; congenital anomalies ; BOH ; bad obstetric history ; TORCH ; Toxoplasmosis Rubella Cyto Megalo Virus Herpes Simplex Virus
• 刊名：Egyptian Journal of Medical Human Genetics
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：18
• 期：1
• 页码：79-85
• 全文大小：679 K
• 卷排序：18

文摘

High Risk Pregnancy (HRP) is a condition where mother or developing fetus or both are at increased risk of complications during or after pregnancy and birth. There are no studies so far which have characterized congenital anomalies (CAs) in HRP women with different previous obstetric histories.AimThe present study was aimed to determine the prevalence, types and distribution of various CAs and also to find out the exact risk factors for different obstetric histories.Subjects and methodsA total of 3301 HRP women (2011–2014) were enrolled. Diagnosis was made using 3D/4D ultrasound. Serum was analyzed for IgG & IgM against TORCH (Toxoplasma, Rubella, CMV and HSV) agents by ELISA. Eleven percent were pregnant women carrying fetuses with CAs in the present pregnancy, while remaining 89% were with bad obstetric history (BOH) and other medical and obstetric complications.ResultsEleven percent pregnant women were carrying fetuses with CAs in the present pregnancy. The major CAs observed were Central Nervous System (CNS) followed by renal anomalies. Maternal age (⩽25 years, OR = 1.42, p = 0.002), paternal age (<30 years, OR = 1.51, p < 0.001), consanguinity (OR = 1.39, p = 0.012) and primi gravida (OR = 3.40, p < 0.001) were identified as risk factors for HRP women with fetal CAs in present pregnancy. Maternal age ⩽25 years and paternal age <30 years conferred around 2-fold risk toward CAs in primi gravida women (p < 0.001) whereas consanguinity was associated with CAs in HRP women with BOH (OR = 1.95, p < 0.018). Toxoplasmosis played a significant role in pregnant women with CAs in present pregnancy with previous normal pregnancies (OR = 4.45, p = 0.009).ConclusionHigh prevalence of CAs was found in HRP women compared to general population. Low parental age contributed toward CAs in primi gravida women while consanguinity was found to be a predisposing factor for CAs in HRP with previous BOH. Toxoplasmosis conferred risk for CAs in HRP women with previous normal pregnancies.