孕早期重大负性生活事件与子代先天性心脏病病因的关联  

Research on the Correlation between Maternal Negative Major Life Events and Congenital Heart Disease during Early Pregnancy

作　　者：刘凤[1] 陶芳标[1] 

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥230032

出　　处：《实用儿科临床杂志》2008年第13期988-990,共3页Journal of Applied Clinical Pediatrics

基　　金：国家科技支撑计划重大项目资助(2006BAI05A03)

摘　　要：目的探讨孕早期重大负性生活事件与子代先天性心脏病(CHD)发生之间的关联。方法查阅4-2-1体检筛查,并经市级以上医院确诊的CHD患儿资料,按1:2配对病例对照研究方法,采用面对面结构式访谈和电话访谈相结合的方式调查116例CHD患儿及232例健康对照儿童的父母人口统计学资料(包括孕前1a的工作环境中是否接触到有毒有害物质等)、母亲既往不良妊娠史、孕期情况(包括孕早期重大负性生活事件、孕早期感冒史、孕早期发热史等环境因素暴露),运用单因素条件Logistic回归分析对研究因素初筛,然后对初选的可疑危险因素进行共线性诊断,排除变量间的共线性关系后用多因素条件Logistic逐步回归作进一步筛选。结果母亲孕早期重大负性生活事件暴露、既往不良妊娠史、孕早期服用药物是子代发生CHD的可能危险因素,且孕早期重大负性生活事件暴露在所有危险因素中作用最强(OR=1.810)。结论加强孕早期母亲心理保健,控制或减少孕早期重大负性生活事件,可能降低子代CHD的发病危险。Objective To determine the relationship between maternal negative major life events during the first trimester and incidence of congenital heart diseases（CHD） in their offspring. Methods The 4 - 2 - 1 medical information was referred and screen CHD children who were confirmed by Municipal hospitals over. A 1 ： 2 case - control study was carried out with face - to - face structured interviews and tele- phone interviews to investigate parents of 116 children with CHD and 232 healthy matched children,including the parents＇ demographic varia- bles （such as whether the working environment exposure to toxic and hazardous substances 1 year before pregnancy,et al）, mother＇s experience of previous adverse pregnancy, duration of pregnancy condition （ such as maternal negative major life events during the first trimester, the histo- ry of catching a cold or fever during the first trimester. The possible risk factors were analyzed by simple factors Logistic regression methods. Then,diagnosing the colinearity among these suspicious risk factors,and rejecting it if necessary. Finally, multiple factors conditional Logistic stepwise regression was used to filter once more. Results The results revealed that maternal negative major life events and taking medicine during the first trimester, mother＇s experience of previous adverse pregnancy were related to the occurrence of CHD in the offspring. Moreover, maternal negative major life events during the first trimester play the most important role（ OR = 1. 810）. Conclusions Strengthening mothers＇ mental health and controlling or reducing maternal negative major life events during the first trimester may be effective in reducing the risk of CHD.

关 键 词：心脏缺损 先天性 病例对照研究 生活事件 

分 类 号：R714.7[医药卫生—妇产科学]