Maternal Hypertension, Diabetes, and Preterm Birth Risk Among Infants With Trisomy 21 in Texas, 1999–2018

IF 2 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2026-08-20 DOI:10.1002/bdr2.70107

Fatima R. Sheriff, Renata H. Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A. J. Agopian

{"title":"Maternal Hypertension, Diabetes, and Preterm Birth Risk Among Infants With Trisomy 21 in Texas, 1999–2018","authors":"Fatima R. Sheriff, Renata H. Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A. J. Agopian","doi":"10.1002/bdr2.70107","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The preterm birth rate among infants with trisomy 21 is more than twice the rate among the general population. Maternal hypertension and diabetes are established risk factors for preterm birth in the general population; however, their impact on pregnancies of infants with trisomy 21 is unknown. This study aimed to evaluate the association between maternal hypertensive disorders/diabetes and preterm birth among infants with trisomy 21.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We utilized data from the Texas Birth Defects Registry for deliveries between 1999 and 2018 (<i>n</i> = 9355). We conducted Poisson regression to estimate crude and adjusted risk ratios for preterm birth associated with any maternal hypertension and any diabetes, and their subtypes (pregestational, gestational). We also evaluated the risk associated with exposure to both (co-occurring) conditions compared to neither. Stratified analyses were conducted by racial/ethnic subgroups, preterm subtypes (< 32 weeks and 32–36 weeks), and presence/absence of congenital heart defects as part of secondary analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We found that maternal hypertension and diabetes were associated with 50% and 21% higher risk for preterm birth, respectively, while the presence of both conditions versus neither was associated with a 71% higher risk. The association with hypertension was much stronger for delivery at < 32 weeks aRR 2.60 (95% CI 1.83, 3.70) than for delivery at 32–36 weeks aRR 1.46 (95% CI 1.28, 1.66).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our findings shed light on the role of maternal hypertension and diabetes in preterm birth risk among infants with trisomy 21, particularly when both conditions co-occur and for extremely to very preterm birth.</p>\n </section>\n </div>","PeriodicalId":9121,"journal":{"name":"Birth Defects Research","volume":"118 8","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bdr2.70107","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Birth Defects Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/bdr2.70107","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DEVELOPMENTAL BIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The preterm birth rate among infants with trisomy 21 is more than twice the rate among the general population. Maternal hypertension and diabetes are established risk factors for preterm birth in the general population; however, their impact on pregnancies of infants with trisomy 21 is unknown. This study aimed to evaluate the association between maternal hypertensive disorders/diabetes and preterm birth among infants with trisomy 21.

Methods

We utilized data from the Texas Birth Defects Registry for deliveries between 1999 and 2018 (n = 9355). We conducted Poisson regression to estimate crude and adjusted risk ratios for preterm birth associated with any maternal hypertension and any diabetes, and their subtypes (pregestational, gestational). We also evaluated the risk associated with exposure to both (co-occurring) conditions compared to neither. Stratified analyses were conducted by racial/ethnic subgroups, preterm subtypes (< 32 weeks and 32–36 weeks), and presence/absence of congenital heart defects as part of secondary analyses.

Results

We found that maternal hypertension and diabetes were associated with 50% and 21% higher risk for preterm birth, respectively, while the presence of both conditions versus neither was associated with a 71% higher risk. The association with hypertension was much stronger for delivery at < 32 weeks aRR 2.60 (95% CI 1.83, 3.70) than for delivery at 32–36 weeks aRR 1.46 (95% CI 1.28, 1.66).

Conclusions

Our findings shed light on the role of maternal hypertension and diabetes in preterm birth risk among infants with trisomy 21, particularly when both conditions co-occur and for extremely to very preterm birth.

查看原文本刊更多论文

1999-2018年，美国德克萨斯州21三体婴儿的母亲高血压、糖尿病和早产风险

背景21三体婴儿的早产率是一般人群的两倍多。孕妇高血压和糖尿病是一般人群中早产的确定危险因素；然而，它们对21三体婴儿怀孕的影响尚不清楚。本研究旨在评估母亲高血压疾病/糖尿病与21三体婴儿早产之间的关系。方法：我们利用1999年至2018年期间德克萨斯州出生缺陷登记处（n = 9355）的分娩数据。我们使用泊松回归来估计与任何母体高血压和任何糖尿病及其亚型（妊娠期、妊娠期）相关的早产的粗风险比和校正风险比。我们还评估了暴露于这两种情况（同时发生）与不暴露于这两种情况的风险。分层分析按种族/民族亚组、早产亚型（32周和32 - 36周）以及是否存在先天性心脏缺陷作为次要分析的一部分进行。结果我们发现，孕妇高血压和糖尿病分别与早产风险增加50%和21%相关，而两种情况的存在与不存在的风险增加71%相关。32周分娩与高血压的相关性为2.60 (95% CI 1.83, 3.70)，而32 - 36周分娩与高血压的相关性为1.46 （95% CI 1.28, 1.66）。结论：我们的研究结果揭示了母亲高血压和糖尿病在21三体婴儿早产风险中的作用，特别是当这两种情况同时发生以及极度早产到非常早产时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.