Congenital Abnormalities and Preterm Birth Related to Maternal Illnesses During Pregnancy (eBook)
XXII, 532 Seiten
Springer Netherland (Verlag)
978-90-481-8620-4 (ISBN)
The major objective of our studies in the last decade was a systematic analysis of maternal diseases during pregnancy to reveal their possible adverse effects on birth outcomes. The two most important factors of infant mortality were parti- larly analyzed: structural birth defects, known as congenital abnormalities (CAs) and preterm birth (PB). In general the objectives of scienti c studies might be either to test a new hypothesis or to con rm or confront previously published results. However, less frequently the authors/scientists have personal motivations determined by their professional activities. The authors of this book are practicing physicians and genetic epidemiologist who are mainly interested in the following three practical questions: 1. The possible adverse effects of pharmaceutical products. The possible t- atogenic potential of about 170 drugs has been evaluated very thoroughly using the data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) in the last 50 years. These drugs were used to treat maternal diseases and the ndings of our population-based case-control studies will be cited in this book and are shown in the Appendix at the end of the book. However, our long experiences showed two problems in the drug teratology. In general the evaluation of clinical doses of these drugs is a particularly dif- cult challenge due to the modi cation effects of confounders. This problem motivated one of the authors to establish a new model of disaster epidemiology.
Contents 5
Introduction 16
Technical Notes 20
Part I The Study Population and Methods 22
1 The Hungarian Congenital Abnormality Registry (HCAR) 23
1.1 Materials and Methods 24
1.2 The Data Base of the HCAR 32
1.3 Quality Control of the HCAR 34
1.3.1 Study Populations and Samples 34
1.3.2 Completeness of Notification 34
1.3.3 The Validity of CA-Diagnoses 35
1.4 The Weaknesses of the HCAR 38
1.5 The Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) 40
1.5.1 Study Groups 41
1.5.2 Collection of Exposure and Other Data 41
1.5.3 Classification of CA-Groups 43
1.6 The Strengths and Weaknesses of the HCCSCA 50
1.6.1 The Maternal Disease Itself 50
1.6.2 Source of Exposure Information 51
1.6.3 The Time Factor 52
1.6.4 Confounding Factors 58
1.6.4.1 Related Drug Treatments 58
1.6.4.2 Concomitant or Other Maternal Diseases 59
1.6.4.3 Maternal Factors 60
1.6.4.4 Lifestyle Factors 60
1.6.4.5 Folic Acid and Folic Acid Containing Micronutrient Combination (The So-Called Multivitamin) Supplementations 62
1.6.5 The Evaluation of Possible Risk 62
1.7 Preterm Birth and Low Birth Weight Newborns 63
1.7.1 Definitions 65
1.7.2 The Hungarian Data of Preterm Births 65
1.8 The Data Set of the HCCSCA, 19801996 67
1.8.1 Maternal Diseases 68
1.8.2 Statistical Analysis 69
1.8.2.1 Case-Control Approach 69
1.8.2.2 Cohort Approach 75
1.9 Budapest Monitoring System of Self-Poisoning Pregnant Women 76
1.10 Final Conclusions 77
Part II Results of Studies and Their Interpretation 82
2 Certain Infectious and Parasitic Diseases 83
2.1 Intestinal Infectious Diseases with the Leading Symptom of Diarrhea 85
2.1.1 Salmonellosis (Salmonella Gastroenteritis) 85
2.1.1.1 Results of the Study (I) 85
2.1.2 Infectious Diarrhea 86
2.1.2.1 Results of the Study (I) 86
2.1.2.2 Interpretation of Results 90
2.2 Tuberculosis 91
2.2.1 Interpretation of Data in the HCCSCA 92
2.3 Varicella (Chickenpox) and Herpes Zoster 92
2.3.1 Results of the Study (X) 93
2.3.2 Interpretation of Results 94
2.4 Herpes Simplex 95
2.4.1 Orofacial Herpes 95
2.4.1.1 Results of the Study (XI, XII) 96
2.4.1.2 Interpretation of Results 97
2.4.2 Genital Herpes 100
2.4.2.1 Results of the Study (XV) 101
2.4.2.2 Interpretation of Results 102
2.5 Measles (Rubeola, Morbilli) 104
2.5.1 Interpretation of Data in the HCCSCA 105
2.6 Rubella 105
2.6.1 Interpretation of Data in the HCCSCA 106
2.7 Viral Hepatitis 107
2.7.1 Interpretation of Data in the HCCSCA 109
2.8 Mumps 109
2.8.1 Interpretation of Data in the HCCSCA 110
2.9 Viral Genital Warts (Condylomata Acuminata) 110
2.9.1 Results of the Study (XVII) 111
2.10 Cytomegalovirus 111
2.10.1 Interpretation of Data in the HCCSCA 113
2.11 Other or Unspecified Viral Infections 113
2.11.1 Interpretation of Data in the HCCSCA 113
2.12 Syphilis 116
2.12.1 Interpretation of Data in the HCCSCA 117
2.13 Gonococcal Infection 117
2.13.1 Interpretation of Data in the HCCSCA 118
2.14 Dermatomycosis 118
2.14.1 Interpretation of Data in the HCCSCA 118
2.15 Toxoplasmosis 119
2.15.1 Interpretation of Data in the HCCSCA 120
2.16 Ascaris 121
2.16.1 Interpretation of Data in the HCCSCA 121
2.17 Scabies 122
2.17.1 Interpretation of Data in the HCCSCA 122
2.18 Final Conclusions 122
3 Neoplasms 129
3.1 Breast Cancer 129
3.1.1 Interpretation of Data in the HCCSCA 129
3.2 Cervical Cancer 130
3.2.1 Interpretation of Data in the HCCSCA 130
3.3 Thyroid Cancer 130
3.3.1 Interpretation of Data in the HCCSCA 131
3.4 Uterine Leiomyoma 131
3.4.1 Results of the Study (I) 131
3.4.2 Interpretation of Results 132
3.5 Others 132
3.6 Conclusions 134
4 Diseases of the Blood and Blood-Forming Organs 135
4.1 Anemia 135
4.1.1 Results of the Study (I) 135
4.1.2 Interpretation of Results 138
4.2 Von Willebrands Disease 140
4.2.1 Interpretation of Data in the HCCSCA 140
4.3 Others 140
4.4 Conclusion 140
5 Endocrine, Nutritional and Metabolic Diseases 142
5.1 Thyroid Diseases in Pregnancy 142
5.2 Simple Goiter 144
5.2.1 Interpretation of Data in the HCCSCA 144
5.3 Hypothyroidism 144
5.3.1 Interpretation of Data in the HCCSCA 145
5.4 Hyperthyroidism 146
5.4.1 Results of the Study 146
5.4.2 Interpretation of Results 148
5.5 Carbohydrate Metabolism 149
5.6 Diabetes Mellitus 149
5.6.1 Results of the Study (IV, V) 152
5.6.2 Interpretation of Results 156
5.7 Obesity 159
5.7.1 Interpretation of Data in the HCCSCA 159
5.8 Others 160
5.8.1 Hyperparathyroidism 160
5.8.2 Diabetes Insipidus 160
5.8.3 Cushing's Syndrome 160
5.8.4 Addison Disease 161
5.8.5 Wilson Disease 161
5.9 Final Conclusion 161
6 Mental and Behavioural Disorders 165
6.1 Schizophrenia 165
6.1.1 Interpretation of Data in the HCCSCA 166
6.2 Manic-Depression Disorders 166
6.2.1 Interpretation of Data in the HCCSCA 167
6.3 Panic Disorders 167
6.3.1 Results of the Study (I, II) 168
6.3.2 Interpretation of the Results 172
6.4 Other Anxiety Disorders 175
6.4.1 Interpretation of Data in the HCCSCA 175
6.5 Alcohol Dependence Syndrome and Drunkenness 175
6.5.1 Interpretation of Data in the HCCSCA 175
6.6 Mental Retardation 176
6.6.1 Interpretation of Data in the HCCSCA 176
6.7 Final Conclusions 176
7 Diseases of the Nervous System 179
7.1 Multiple Sclerosis 179
7.1.1 Interpretation of Data in the HCCSCA 179
7.2 Epilepsy 180
7.2.1 Results of the Study (I, VI) 182
7.2.2 The Interpretation of Results 187
7.3 Migraine 190
7.3.1 Results of the Study (VII, VIII) 192
7.3.2 Interpretation of Results 197
7.3.3 General Recommendations Regarding to the Treatment of Pregnant Women with Migraine 201
7.4 Other Headaches 202
7.4.1 Results of the Study 202
7.4.2 Interpretation of Results 203
7.5 Final Conclusions 203
8 Diseases of the Eye and Adnexa 208
8.1 Interpretation of Data in the HCCSCA 208
9 Diseases of the Ear and the Mastoid Process 209
9.1 Otitis Media 209
9.1.1 Results of the Study (I) 209
9.1.2 Interpretation of Results 212
9.2 Other Diseases 213
10 Diseases of the Circulatory System 214
10.1 Maternal Cardiovascular Adaptation to Pregnancy 214
10.2 Mitral Stenosis Due to Rheumatic Heart Disease 215
10.2.1 Interpretation of Data in the HCCSCA 215
10.3 Hypertension 215
10.3.1 Results of the Study (I, II) 216
10.3.2 Interpretation of Results 221
10.4 Preeclampsia-Eclampsia 223
10.4.1 Results of the Study 224
10.4.2 Interpretation of Results 227
10.5 Coronary Artery Disease 231
10.5.1 Results of the Study 231
10.5.2 Interpretation of Results 233
10.6 Cardiac Dysrhythmias 235
10.7 Paroxysmal Supraventricular Tachycardia 235
10.7.1 Results of the Study 235
10.7.2 Interpretation of Results 237
10.8 Extrasystolic Arrhythmia 238
10.8.1 Interpretation of Data in the HCCSCA 239
10.9 Conduction Disorders 239
10.9.1 Interpretation of Data in the HCCSCA 239
10.10 Phlebitis, Thrombophlebitis, and Pulmonary Embolism 239
10.10.1 Results of the Study 240
10.10.2 Interpretation of Results 242
10.11 Varicose Veins of the Lower Extremities 244
10.11.1 Results of the Study (VI) 244
10.11.2 Interpretation of the Results 246
10.12 Hemorrhoids 247
10.12.1 Results of the Study 247
10.12.2 Interpretation of Results 250
10.13 Hypotension 252
10.13.1 Results of the Study 252
10.13.2 Interpretation of Results 254
10.14 Others 256
10.14.1 Interpretation of Data in the HCCSCA 256
10.15 General Conclusion 256
11 Diseases of the Respiratory System 263
11.1 Respiratory System and Respiratory Function During Pregnancy 263
11.2 Common Cold 264
11.2.1 Results of the Study (I, II) 264
11.2.2 Interpretation of Results 268
11.3 Acute Infectious Diseases of the Respiratory System 268
11.3.1 Results of the Study (IV, V) 269
11.3.2 Interpretation of Results 272
11.4 Pleurisy 273
11.4.1 Interpretation of Data in the HCCSCA 273
11.5 Influenza 274
11.5.1 Results of the Study (VII, VIII) 274
11.5.2 Interpretation of Results 276
11.6 Chronic Bronchitis and Emphysema 278
11.6.1 Interpretation of Data in the HCCSCA 278
11.7 Allergic Rhinitis 278
11.7.1 Results of the Study (XIII) 279
11.7.2 Interpretation of Results 281
11.8 Bronchial Asthma 281
11.8.1 The results of the Study (XIV, XV) 282
11.8.2 Interpretation of Results 285
11.9 Others 287
11.10 Final Conclusions 287
12 Diseases of the Digestive System 291
12.1 Alterations in Gastrointestinal and Liver Functions during Pregnancy 291
12.2 Disorders of the Teeth 292
12.3 Periodontal Diseases 292
12.3.1 Results of the Study (I) 292
12.3.2 Interpretation of Results 296
12.4 Nausea and Vomiting in Pregnancy 297
12.4.1 Results of the Study (II--IV) 298
12.4.2 Interpretation of Results 301
12.5 Dyspepsia and Gastro-Oesophageal Reflux Disease 306
12.5.1 Results of the Study (V) 306
12.5.2 Interpretation of Results 308
12.6 Gastritis and Duodenitis 310
12.6.1 Interpretation of Data in the HCCSCA 310
12.7 Peptic Ulcer Disease 311
12.7.1 Results of the Study 311
12.7.2 Interpretation of Results 312
12.8 Appendicitis 314
12.8.1 Results of the Study (VI) 314
12.8.2 Interpretation of Results 315
12.9 Ulcerative Colitis 316
12.9.1 Results of the Study (VIII) 317
12.9.2 Interpretation of Results 318
12.10 Crohn Disease 319
12.10.1 Interpretation of Data in the HCCSCA 320
12.11 Constipation 320
12.11.1 Results of the Study (IX) 320
12.11.2 Interpretation of Results 323
12.12 Intrahepatic Cholestasis of Pregnancy 325
12.12.1 Interpretation of Data in the HCCSCA 325
12.13 Cirrhosis of Liver 326
12.13.1 Interpretation of Data in the HCCSCA 326
12.14 Cholecystitis 326
12.14.1 Results of the Study (X) 326
12.14.2 Interpretation of Results 328
12.15 Cholelithiasis (Gallstone Disease) 330
12.15.1 Results of the Study (X) 330
12.15.2 Interpretation of Results 331
12.16 Cholangitis 332
12.16.1 Interpretation of Data in the HCCSCA 333
12.17 Pancreatitis 333
12.17.1 Interpretation of Data in the HCCSCA 333
12.18 Hernias 333
12.18.1 Interpretation of Data in the HCCSCA 333
12.19 Final Conclusions 334
13 Diseases of the Skin and Subcutaneous Tissue 341
13.1 Atopic Dermatitis 341
13.1.1 Interpretation of Data in the HCCSCA 341
13.2 Psoriasis 342
13.2.1 Interpretation of Data in the HCCSCA 342
13.3 Pruritus 343
13.3.1 Interpretation of Data in the HCCSCA 343
13.4 Allergic Urticaria 344
13.4.1 Interpretation of Data in the HCCSCA 344
13.5 Others 344
13.6 General Conclusions 345
References 345
14 Diseases of the Musculoskeletal System and Connective Tissue 346
14.1 Rheumatoid Arthritis 346
14.1.1 Interpretation of Data in the HCCSCA 346
14.2 Intervertebral Disc Disorders (Lumbago) 347
14.2.1 Interpretation of Data in the HCCSCA 348
14.3 Rheumatism, Myalgia, Neuralgia 348
14.3.1 Interpretation of Data in the HCSSCA 349
14.4 Pain in Hip Join 349
14.4.1 Interpretation of Data in the HCCSCA 349
14.5 Others 350
14.6 Final Conclusions 350
15 Diseases of the Urinary Tract 352
15.1 Maternal Renal Adaptation to Pregnancy 352
15.2 Glomerulonephritis 353
15.2.1 Results of the Study (I) 353
15.2.2 Interpretation of the Results 355
15.3 Urinary Tract Infections 358
15.3.1 Results of the Study (III, IV) 359
15.3.2 Interpretation of Results 365
15.4 Kidney Stones 367
15.4.1 Results of the Study (IX) 367
15.4.2 Interpretation of Results 369
15.5 Chronic Kidney Diseases with Secondary Hypertension 370
15.5.1 Interpretation of Data in the HCCSCA 371
15.6 Other Renal Diseases 371
15.7 Final Conclusions 372
16 Diseases of the Genital Organs 375
16.1 Pelvic Inflammatory Diseases 375
16.1.1 Results of the Study (I) 376
16.1.2 Interpretation of Results 379
16.2 Vulvovaginitis and Bacterial Vaginosis 381
16.2.1 Results of the Study (VI, VII) 382
16.2.2 Interpretation of Results 386
16.3 Erosion of the Cervix with or Without Cervicitis 389
16.3.1 Results of the Study (X) 390
16.3.2 Interpretation of Results 391
16.4 Cyst and/or Abscess of the Bartholin Gland 393
16.4.1 Interpretation of Data in the HCCSCA 394
16.5 Endometriosis 394
16.5.1 Interpretation of Data in the HCCSCA 394
16.6 Ovarian Cysts 395
16.6.1 Results of the Study (XI) 395
16.6.2 Interpretation of Results 397
16.7 Polyp of the Cervix or Corpus Uteri 398
16.7.1 Interpretation of Data in the HCCSCA 399
16.8 Cervical Incompetence 399
16.8.1 Results of the Study (XIII) 400
16.8.2 Interpretation 409
16.9 Non-inflammatory Disorders of Vagina and Vulva 417
16.9.1 Interpretation of Data in the HCCSCA 417
16.10 Cystic Mastopathy of the Breast 417
16.11 Conclusions 418
17 Pregnancy, Childbirth, and the Pueperium 424
17.1 Threatened Abortion 425
17.2 Placental Disorders 428
17.3 Pathological Forms of Amnion Fluid 430
17.4 Oedema and Excessive Weight Gain Without Hypertension 431
17.5 Threatened Preterm Delivery 432
17.6 Others 433
17.7 Conclusions 433
References 433
18 Congenital Malformations, Deformations, and Chromosomal Abnormalities 434
18.1 Cardiovascular CAs 434
18.1.1 Interpretation of Data in the HSCCSCA 434
18.2 CA of the Uterus 435
18.2.1 Results of the Study 435
18.2.2 Interpretation of Results 437
18.3 Congenital Dislocation of the Hip 438
18.3.1 Interpretation of Data in the HCCSA 438
18.4 Others 439
18.5 Conclusions 439
Part III Summary of Results and Recommendations 442
19 Association of Maternal Diseases During Pregnancy with Higher Risk of Congenital Abnormalities (CAs) in Their Children 443
19.1 High Fever Related Maternal Diseases During Pregnancy and CAs in Their Offspring 443
19.1.1 Neural-Tube Defects (NTD) 445
19.1.2 Microcephaly 446
19.1.3 Congenital Cataract 446
19.1.4 Orofacial Clefts 447
19.1.5 Cardiovascular Malformations 447
19.1.6 Congenital Limb Deficiencies 447
19.1.7 Multiple Congenital Abnormalities (MCAs) 448
19.1.8 Conclusions 455
19.2 Confirmed Associations of Maternal Diseases with CA 456
19.2.1 Diabetes Mellitus, Type 1 456
19.2.2 Epilepsy 457
19.2.3 Infectious Teratogenic and Fetopathogenic Agents 458
19.2.4 Cardiovascular CAs in Pregnant Women 460
19.2.5 Conclusions 460
19.3 Unexpected Association of Maternal Disease During Pregnancy With Higher Risk of CAs in Their Children But With Reasonable Etiological Hypothesis 461
19.3.1 Migraine 461
19.3.2 Paroxysmal Supraventricular Tachycardia 461
19.3.3 Ovarian Follicular Cysts 462
19.3.4 CAs of the Uterus 462
19.4 Unexpected Strong Association of Maternal Disease During Pregnancy With Higher Risk of CAs in Their Children But Without Reasonable Etiological Hypothesis 463
19.4.1 Panic Disorder 463
19.4.2 Coronary Artery Disease 464
19.4.3 Periodontal Infectious Diseases 464
19.5 Unexpected Weak Association of Maternal Disease During Pregnancy With Higher Risk of CAs in Their Children With or Without Plausible Hypothesis 464
19.5.1 Hyperthyroidism 465
19.5.2 Otitis Media 465
19.5.3 Essential Hypertension 466
19.5.4 Varicose Veins of the Lower Extremities 466
19.5.5 Hemorrhoids 467
19.5.6 Dyspepsia and Gastro-Oesophageal Reflux Disease 467
19.5.7 Ulcerative Colitis 467
19.5.8 Glomerulonephritis 468
19.5.9 Erosion of Cervix 468
19.6 Conclusions 469
19.7 The Teratogenic Potential of Related Drug Treatments 469
19.7.1 Antiepileptic Drugs 470
19.7.2 Ergotamine 471
19.7.3 Certain Antihypertensive Drugs 471
19.7.4 ''Warfarin'' 472
19.7.5 Methimazole 473
19.7.6 Phenolphthalein 473
19.8 The So-called Antiteratogenic Drugs 474
19.8.1 Antipyretic Drugs 474
19.8.2 Insulin 475
19.8.3 Antipanic Drugs 476
19.9 Conclusions 477
19.10 Maternal Diseases with Preventive Effect on CAs 477
19.10.1 Nausea and Vomiting in Pregnancy 478
19.10.2 Cervical Incompetence 479
19.10.3 Conclusions 480
19.11 Primary Prevention of CAs 480
19.11.1 Vaccination 480
19.11.2 Avoidance of Teratogens 481
19.11.3 Folic Acid or Folic Acid-Containing Multivitamin Supplementation in General 482
19.11.3.1 Historical Background 482
19.11.3.2 Results of the Hungarian RCT 483
19.11.3.3 Results of the Hungarian Cohort Controlled Trial 485
19.11.4 Folic Acid or Multivitamin in Reduction of Maternal Disease Related CAs 491
19.11.4.1 High Fever Related Maternal Diseases 491
19.11.4.2 Maternal Epilepsy 491
19.11.4.3 Maternal Diabetes Mellitus 492
19.12 General Conclusions 492
20 Associations of Maternal Diseases with Higher Risk for Pretem Birth (PB) and Low Birth Weight (LBW) Newborns 497
20.1 Local Causes 497
20.1.1 CA of the Uterus 497
20.1.2 Cervical Incompetence 498
20.2 Microbial Causes 498
20.2.1 Acute Maternal Infectious Diseases During the Study Pregnancy 498
20.2.2 Urinary Tract Infections 500
20.2.3 Infections of the Genital Organs 501
20.2.3.1 Diseases of the Upper Genital Organs 501
20.2.3.2 Infections/Diseases of the Lower Genital Organs 502
20.2.3.3 Genital Herpes 502
20.2.3.4 Viral Genital Warts 503
20.3 Chronic Maternal Diseases During Pregnancy 503
20.4 Pregnancy Complications During the Study Pregnancy 507
20.5 General Discussion 508
20.6 Specific Prevention of PB and LBW 509
20.6.1 The Medical Management of Cervical Incompetence in Pregnant Women 509
20.6.2 Prevention of Urinary Tract Infections 510
20.6.3 Prevention of Vulvovaginitis-Bacterial Vaginosis 510
20.6.4 Prevention of Bronchial Asthma Related PB 511
20.6.5 Prevention of Iron Deficient Anemia Related PB 512
20.7 General Prevention of PB 512
20.7.1 Results of the Study (I) 513
20.7.2 Interpretation of the Study 514
20.8 General Conclusions 518
20.9 Final Conclusion 518
Closing Remarks 521
Appendix 523
1 Studies Based on the HCCSCA 523
A Antimicrobial Drugs 523
B Other Drugs 526
C Pregnancy Supplements 529
2. Studies Based on the Budapest Monitoring System of Self-Poisoned Pregnant Women 530
3. Intervention Trials of Folic Acid-Containing Multivitamin Supplementation Based on the Hungarian Periconceptional Service 531
Index 532
| Erscheint lt. Verlag | 5.7.2010 |
|---|---|
| Zusatzinfo | XXII, 532 p. |
| Verlagsort | Dordrecht |
| Sprache | englisch |
| Themenwelt | Sachbuch/Ratgeber ► Gesundheit / Leben / Psychologie ► Krankheiten / Heilverfahren |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Gynäkologie / Geburtshilfe | |
| Studium ► Querschnittsbereiche ► Epidemiologie / Med. Biometrie | |
| Schlagworte | Birth • Child • complications • Diagnosis • maternal and child health • Monitoring • Population • Pregnancy • prevention • Primary prevention • Radiologieinformationssystem |
| ISBN-10 | 90-481-8620-X / 904818620X |
| ISBN-13 | 978-90-481-8620-4 / 9789048186204 |
| Haben Sie eine Frage zum Produkt? |
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