Major congenital anomalies in children born to women with systemic lupus erythematosus
Notice bibliographique
Résumé
Systemic lupus erythematosus (SLE) can cause considerable morbidity during pregnancy. Although several studies have evaluated fetal outcome in lupus pregnancy, only one small study assessed congenital anomalies in 30 children born to SLE mothers, showing no excess risk. In a large population-based study, we aimed to determine whether children born to women with SLE have an increased risk of major congenital anomalies compared with children born to women without SLE. We identified all women who had ≥1 hospitalization for a delivery after SLE diagnosis using Quebec's physician billing and hospitalization databases (1989 to 2009). Women were defined as SLE cases if they had any of the following: ≥1 hospitalization with a diagnosis of SLE prior to the delivery; a diagnosis of SLE recorded at the time of their hospitalization for delivery; or ≥2 physician visits with a diagnosis of SLE, occurring 2 to 24 months apart, prior to the delivery. We randomly selected a general population control group, composed of women matched at least 4:1 for age and year of delivery, who did not have a diagnosis of SLE prior to or at the time of delivery. We identified children born live to SLE cases and their matched controls, and obtained information on all physician visits and hospitalizations incurred by these children. We ascertained major congenital anomalies, as defined by ≥1 hospitalization or physician visit with an ICD-9/10 diagnostic code for major congenital anomaly, within the first 12 months of life. We performed multivariate analyses to adjust for maternal demographics (that is, age, education, marital status), sex and birth order of child, major maternal co-morbidities (that is, pre-gestational diabetes, hypertension, asthma, depression), and relevant maternal medications (that is, antimalarials, corticosteroids, immunosuppressants). A total of 507 women with SLE had 721 children, while 5,862 matched controls had 8,561 children. Compared with controls, children born to women with SLE experienced slightly more major congenital anomalies (13.6% (95% CI = 11.3 to 16.3) vs. 10.4% (95% CI = 9.7 to 11.1)). In multivariate analyses, children born to women with SLE had a substantially increased risk of major congenital anomalies (adjusted OR = 1.28, 95% CI = 1.01 to 1.62) compared with controls. Medication exposures did not seem to mediate the risk of major congenital anomalies. Our findings suggest that, compared with children from the general population, children born to women with SLE have an increased risk of major congenital anomalies, and prompt further research to elucidate this issue.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».