First trimester maternal infections and offspring congenital heart defects: a meta-analysis.

This study aims to synthesize contemporary evidence on the association between first-trimester maternal infection and risk of offspring CHD.

本研究旨在综合当前证据，探讨孕早期母体感染与后代CHD风险之间的关联。

Methods

This systematic reviewand meta-analysis(PROSPERO number: CRD42024523638) used Embase, PubMed, Web of Science, Scopus, and the Cochrane Library to identify studies investigating first-trimester maternal infection and offspring CHD, published up until 30 September 2024.

这项系统评价和荟萃分析（PROSPERO编号：CRD42024523638）使用了Embase、PubMed、Web of Science、Scopus和Cochrane图书馆来识别研究首次妊娠期母体感染与后代先天性心脏病（CHD）的研究，发表日期截止至2024年9月30日。

Human studies with a minimum of 50 cases were eligible.

至少包含50个病例的人类研究是符合条件的。

Inverse variance weighted random-effects models were conducted to pool estimates and stratify associations by infection type and heart defect type.

采用逆方差加权随机效应模型进行估计汇总，并按感染类型和心脏缺陷类型对关联进行分层。

Results

A total of 30 studies (24 case-control, 3 cohort, and 3 cross-sectional studies) with 1 732 295 pregnancies were identified.

共识别出30项研究（24项病例对照研究、3项队列研究和3项横断面研究），涉及1,732,295例妊娠。

Studies assessed maternal infectious status through self-reported questionnaires (n = 20, 66.7%), laboratory testing (n = 7, 23.3%) or medical records (n = 3, 10.0%).

研究通过自我报告问卷(n = 20, 66.7%)、实验室检测(n = 7, 23.3%)或医疗记录(n = 3, 10.0%)评估了母亲的感染状态。

Overall, any first-trimester maternal infection was associated with higher risk of CHD in offspring, with a pooled odds ratio (OR) and 95% confidence interval(CI) of 1.63 (1.41, 1.88).

总体而言，任何第一孕期母亲的感染都与后代先天性心脏病(CHD)的较高风险相关，汇总后的比值比(OR)及其95%置信区间(CI)为1.63 (1.41, 1.88)。

Among specific types of infection, rubella virus, coxsackievirus, respiratory infections, and influenza presented higher risks of offspring CHD, with ORs (95% CI) of 2.78 (2.08, 3.72), 1.57 (1.12, 2.19), 1.57 (1.25, 1.96), and 1.50 (1.20, 1.87), respectively.

在特定类型的感染中，风疹病毒、柯萨奇病毒、呼吸道感染和流感对后代先天性心脏病(CHD)的风险较高，其比值比(95%置信区间)分别为2.78(2.08, 3.72)、1.57(1.12, 2.19)、1.57(1.25, 1.96)和1.50(1.20, 1.87)。

Studies that reported associations by individual subtype of CHD relied on a comparatively modest number of cases.

依赖于相对较少病例数的报告，研究了按CHD个体亚型分类的关联性。

Pooled ORs for exposure to any first-trimester infection were 1.59 (1.16, 2.20) for ventricular septal defects, 1.55 (1.21, 1.99) for atrioventricular septal defects, and not statistically significant for other subtypes.

孕早期感染的合并比值比（ORs）对于室间隔缺损为1.59（95%置信区间1.16-2.20），对于房室间隔缺损为1.55（95%置信区间1.21-1.99），而对于其他亚型则没有统计学意义。

Conclusions

First-trimester maternal infections are associated with increased risk of offspring CHD and appear to extend beyond infections commonly tested for during routine pregnancy screening.

孕早期母亲感染与后代先天性心脏病（CHD）风险增加有关，并且这种风险似乎超出了常规孕期筛查中通常检测的感染范围。

Larger-scale studies are warranted to confirm these findings using laboratory antibody testing and explore underlying mechanisms.

需要更大规模的研究来通过实验室抗体检测确认这些发现，并探索潜在的机制。