不同人群先天畸形影响因素比较  

Comparative study on influencing factors of congenital malformation in different population

作　　者：赵仲堂[1] 李栋[2] 高莉洁[1] 冯月秋[1] 郝凤荣[1] 姜宝法[1] 周凤荣 张颖[1] 

机构地区：[1]山东大学公共卫生学院流行病与卫生统计学研究所,济南250012 [2]泰山医学院预防医学教研室 [3]山东省妇幼保健研究所

出　　处：《中国公共卫生》2005年第3期293-295,共3页Chinese Journal of Public Health

基　　金：山东省"十大示范工程"项目 (0 4 0 1 0 1 73)

摘　　要：目的　探讨不同人群与围生儿先天畸形发生的相关影响因素 ,为适宜的社区人群干预对策与措施提供科学依据。方法　采用病例对照研究方法 ,以随机抽样方法抽取农村与城市先天畸形病例 ,其中城市 16 9例 ,农村2 0 5例。对照组按 1∶1配比的方法选择出生正常的婴幼儿 374例。调查对象均用统一问卷和调查方法 ,并采集血清标本进行实验室分析。数据用条件Logistic回归模型进行分析。 结果　城市人群与先天畸形相关的因素为孕妇知孕时间长 (OR =5 4 90 ,PAR % =13 91% )、孕早期发热 (OR =3 35 2 ,PAR % =12 18% )、孕早期服用解热镇痛药 (OR=3 5 0 1,PAR % =13 98% )、孕早期接触化学毒物 (OR =3 14 7,PAR % =8 0 9% )、父亲接触有害物 (OR =4 4 95 ,PAR % =9 4 9% )、负性生活事件 (OR =1 113,PAR % =2 4 8% ) ;农村人群与先天畸形相关的因素为孕妇知孕时间长 (OR =3 85 0 ,PAR % =13 34% )、孕期服药 (OR =3 95 2 ,PAR % =2 8 82 % )、孕早期营养 (OR =0 2 2 0 ,PAR % =16 0 3% )、既往巨细胞病毒感染 (OR =2 76 0 ,PAR % =16 0 6 % )、母亲优生知识知晓程度 (OR =0 30 5 ,PAR % =18 0 8% )、负性生活事件 (OR =1 5 0 6 ,PAR % =3 5 6 % )。结论　城市、农村人群先天畸形的影响因素及其作用强度不?Objective To study the influencing factors of congenital malformation in different population and to provide scientific evidence for the decision making of the practical community intervention measures of the disease.Methods Case control studies were carried out with 374 congenital malfomation cases,169 from city and 205 from rural area,collected from Shandong province.Control groups were collected by pair matching method.All of 748 subjects were interviewed by the same questionnaire and their plasma was tested by the same laboratory technique.Simple and multiple conditional Logistic regression models were used for the data analysis.Results Long period from pregnancy to be known,fever(>38?℃)during early pregnancy,taking febricide and anodyne,exposure to hazardous chemicals during pregnancy,paternal exposure to injurants,negative life events during pregnancy were the influencing factors of congenital malformation in the city.And their OR and Population Attributable Risk percent (PAR%) values were 5 490 (13 91%),3 352 (12 18%),3 501 (13 98%),3 147 (8 09%),4 495 (9 49%) and 1 113(2 48%),respectively.Long period from pregnancy to be known,taking medicines during pregnancy,nutrition feeding during early pregnancy,previous cytomegalovirus infection,grade of eugenic knowledge,negative life events during pregnancy were the influencing factors of congenital malformation in rural area.And their OR and PAR% values were 3 850(13 34%),3 952(28 82%),0 220(16 03%),2 760(16 06%),0 305(18 08%) and 1 506 (3 56%) respectively. Conclusion The sorts and function intensities of infuencing factors to the disease were different between city and rural areas.The different intervention strategies and measures should be considered among city and rural population.

关 键 词：先天畸形 影响因素 城市 农村 病例对照研究 

分 类 号：R181.33[医药卫生—流行病学]