2004至2011年广东省胎婴儿先天性心脏病危险因素分析  

Risk factors of congenital heart defects in fetal and infants born from 2004 to 2011 in Guangdong

作　　者：聂志强[1] 欧艳秋[1] 陈寄梅[1] 刘小清[1] 麦劲壮[1] 高向民[1] 吴勇[1] 庄建[1] 

机构地区：[1]广东省心血管病研究所广东省人民医院心外科流行病学研究室广东省医学科学院,广州510080

出　　处：《中华心血管病杂志》2013年第8期704-708,共5页Chinese Journal of Cardiology

基　　金：“十二五”国家科技支撑计划（2011BAIllB22）;国家重点基础研究发展计划（2010CB529500）;广东省科技计划项目（2011B031900002）

摘　　要：目的探讨广东省胎婴儿先天性心脏病（CHD）的危险因素。方法人选2004年7月1日至2011年12月31日在广东省先天性心脏病防治网34个协作医院确诊为CHD的年龄孕28周～1岁胎婴儿。病例组和对照组各2568例，采取1：1配对，配对条件是性别相同、住地相同、出生时问前后相差3个月以内、无心脏缺陷的胎婴儿。收集胎婴儿父母在孕前和孕早期的危险因素暴露情况。结合专业知识纳入单因素有意义的变量，共线性诊断后行CHD危险因素的多因素条件logistic回归分析。结果多因素条件logistic回归分析显示，广东省胎婴儿CHD的危险因素为胎婴儿体质量异常（低体质量OR=5．34，P〈0．01；巨大儿OR=1．67，P〈0．05）、家庭人均月收入低（0～1200元，OR=1．68，P〈0．01）、孕母在孕早期接触化学制剂（OR=19．72，P〈0．01）、流动人口（OR=2．13，P〈0．01）、孕母异常生育史（OR=3．18，P〈0．01）、孕母被动吸烟（OR=2．59，P〈0．01）、孕母发烧（OR：3．74，P〈0．01）、产2次及以上（OR：1．45，P〈0．01）、住装修半年内居室（OR=2．74，P〈0．01）、孕母病毒感染（OR=2．08，P〈0．01）、常住地为农村（OR=1．33，P〈0．01）、居室距离马路50m以内（OR=1．52，P〈0．01）、患梅毒（OR=13．06，P〈0．05）、孕前期父亲饮酒（OR=1．57，P〈0．05）。结论广东省胎婴儿CHD危险因素众多，应针对性地加强孕前期及孕早期综合干预。Objective To analyze the risk factors of congenital heart defects （CHD） in fetal and infants born from 2004 to 2011 in Guangdong province. Methods Babies with CHD aged from 28th week of gestation to 1 year old postnatal from July 1 2004 to December 31 2011 were registered in Guangdong CHD monitoring network with 34 participating units. Totally 2568 CHD cases were included, and 1：1 matched with a normal control cohort by gender, living district and birth date （time span within 3 months ）. Exposed information of mother and father at pre-pregnancy and early pregnancy was collected. Post collinearity diagnostics analysis, univariate analysis results were included in a multivariate analysis model with forward stepwise conditional logistic regression. Results Multivariate conditional logistic regression analysis showed that high risk factors for CHD included low birth weight infant （OR =5.34,P 〈0.01 ）, macrosornia （OR = 1.67 ,P 〈0.05） ,low per capita income （0 - 1200 yuan, OR = 1.68 ,P 〈0. 01 ） , exposure to chemical agent at early pregnancy （ OR = 19. 72, P 〈 0. 01 ）, floating population （ OR = 2. 13, P 〈 0. 01 ）, abnormal reproductive history （ OR = 3.18 ,P 〈 0. 01 ） , exposure to passive smoking （ OR = 2. 59 ,P 〈 0. 01 ） , suffering fi＇om fever （ OR =- 3.74,P 〈 0. 01 ）, equal to or more than twice parity （ OR = 1.45, P 〈 0. 01 ）, living in a newly （ within six months ） -decorated-apartment （ OR = 2. 74, P 〈 0. 01 ）, suffering from virus infection （ OR = 2. 08, P 〈 0. 01 ） , rural residence （ OR = 1.33,P 〈 0. 01 ） , living in an apartment within 50 meters of major traffic road （ OR = 1.52, P 〈 0. 01 ）, syphilis infection at early pregnancy （ OR = 13.06, P 〈 0.05 ） and father＇s drinking habit at pre-pregnancy （ OR = 1.57,P 〈 0.05）. Conclusion Numerous risk factors forCHD in fetal and infants of Guangdong province are indicated by our results, comprehensive intervention should t}e considered in pre-pregnancy and

关 键 词：心脏缺损 先天性 危险因素 胎儿 婴儿 

分 类 号：R725.4[医药卫生—儿科]