舟山海岛地区先天性心脏病危险因素的巢式病例对照研究  

Nested case-control study of risk factors of congenital heart disease in Zhoushan archipelagoe

作　　者：吴金华[1] 陈海兰[1] 陈坤[2] 缪凡[2] 

机构地区：[1]浙江省舟山市妇幼保健院,浙江舟山316000 [2]浙江大学公共卫生学院流行病学教研室

出　　处：《疾病监测》2008年第8期510-514,共5页Disease Surveillance

基　　金：浙江省舟山市医药卫生科技计划项目(05B07)

摘　　要：目的了解浙江省舟山海岛地区先天性心脏病(CHD)的相关影响因素,为寻找降低该地区CHD患病率的防治措施提供线索。方法采用基于人群的巢式病例对照研究设计,从2000-2006年舟山市海岛地区以人群为基础的出生缺陷监测数据库中选择45例先天性心脏病病例,采用1∶3频数匹配随机从数据库中抽取对照135名,进行回顾性分析。结果多因素logistic回归分析结果显示,丈夫年龄、孕前6个月内服避孕药和梅毒检测试验被纳入最后的模型中。与≤25岁组相比,孕妇丈夫年龄26～30岁者会显著增高胎儿患CHD的风险性,OR值为9.61(95%CI:1.17～78.94),而31岁组与其比较差异则无统计学意义。孕前6个月内服避孕药和梅毒感染也都具有危险效应,OR值分别为5.48(95%CI:1.48～20.30)、4.36(95%CI:1.26～15.05)。结论孕前6个月内服用避孕药和梅毒检测阳性对孕妇分娩先天性心脏病患儿的危险性增加,需要采取措施进行干预。Objective The study was conducted to identify the risk factors of congenital heart disease （CHD） in Zhoushan Archipelagoes, providing evidence for the development of corresponding preventive strategies. Methods The nested case-control study was population-based and retrospective, with 45 CHD patients recruited according to the data from the birth defect surveillance database in Zhoushan from 2000 to 2006, and 135 randomized control subjects collected, the ratio of frequency being 1：3. Results According to the results of multivariate logistic regressions, the paternal age, oral contraceptives used within 6 months before pregnancy, and maternal syphilis infections were considered influential variables. Compared with the younger group （with the paternal age ≤25）, pregnant women who had 26-to-30-year-old spouses presented significantly higher risks to have CHD fetuses, the OR being 9.61 （95% CI： 1.17-78.94）, whereas no distinguishable difference was shown when comparing to the 31-year-old group. Exposure to contraceptives or syphilis infections within 6 months before pregnancy also added to the risks, the OR being 5.48 （95%CI：1.48-20.30） and 4.36 （95%CI：1.26-15.05）, respectively. Conclusion Exposure to contraceptives or syphilis infections within 6 months before pregnancy would add to the risks of having fetuses with congenital heart diseases. Therefore, preventive intervention shall be given.

关 键 词：出生缺陷监测 巢式病例对照研究 先天性心脏病 

分 类 号：R725.4[医药卫生—儿科]