Congenital Abnormalities and Preterm Birth Related to Maternal Illnesses During Pregnancy
Samenvatting
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.
Specificaties
Inhoudsopgave
PART A. THE STUDY POPULATION AND METHODS (Andrew E. Czeizel)
I. The Hungarian Congenital Abnormality Registry (HCAR)
II. The Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA)
III. Preterm birth and low birth weight newborns
IV. The Budapest Monitoring System of Self-poisoning Pregnant Women
PART B. RESULTS OF STUDIES AND THEIR INTERPRETATION (Nándor Ács and Ferenc Bánhidy)
I. Certain infectious and parasitic diseases
II. Neoplasms
III. Diseases of blood and blood-forming organs
IV. Endocrine, nutritional and metabolic diseases
V. Mental and behavioural disorders
VI. Diseases of the nervous system
VII. Diseases of eye and adnexa
VIII. Diseases of ear and mastoid process
IX. Diseases of the circulatory system
X. Diseases of the respiratory system
XI. Diseases of the digestive system
XII. Diseases of skin and subcutaneous tissue
XIII. Diseases of the musculoskeletal system and connective tissue
XIV/A. Diseases of urinary tract
XIV/B. Diseases of genital organs
XV. Pregnancy, childbirth and puerperium
XVI. Congenital malformations, deformities and chromosomal abnormalities
PART C: SUMMARY OF RESULTS AND RECOMMENDATIONS (Nándor Ács, Ferenc Bánhidy and Andrew E. Czeizel)
A/ Association of maternal diseases during pregnancy with higher risk of congenital abnormalities (CAs) in their children
I. High fever related maternal diseases during pregnancy and CAs in their offspring
II. Confirmed associations of maternal diseases with CA
III. Unexpected associations of maternal diseases during pregnancy with a higher risk of CA in their children
IV. Teratogenic potential of related drugs treatment
V. Maternal diseases with preventive effect of CAs
VI. Primary prevention of CAs
B/ Association of maternal diseases withthe higher risk of preterm birth (PB) and low birth weight (LBW) newborns
I. Local causes
II. Microbial causes
III. Chronic maternal diseases during the study pregnancy
IV. Pregnancy complications during the study pregnancy
V. Prevention of PB and LBW newborns