孕期危险因素与儿童先天性心脏病关系的Meta分析  

Relationship between Risk Factors during Pregnancy and Congenital Heart Disease in Children:A Meta-analysis

作　　者：谢胜男[1] 李能[1] 王建敏[1] 郑小璇[1] 杨昌友[1] 纪昌文 杨森焙[1] 张静[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系,武汉430030 [2]武汉市江汉区妇幼保健所,武汉420100

出　　处：《华中科技大学学报（医学版）》2013年第5期547-550,559,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省人口和计划生育委员会资助项目(No.JS-20130020)

摘　　要：目的 探讨母亲孕期危险因素与儿童先天性心脏病的关系,为先心病的病因学研究提供科学依据.方法 运用Stata 统计软件对2002～2012年间国内外发表的先天性心脏病影响因素的研究进行Meta分析,通过异质性检验并计算优势比（OR）及95%置信区间（CI）,评估发表偏倚和进行敏感性分析.结果 共有27篇文献纳入,其中病例组24 949人,对照组79 828人.孕期10个因素的合并OR值及95%CI分别为：精神刺激2.977（2.338,3.789）、有害物质暴露1.891（1.254,2.851）、吸烟1.065（1.015,1.117）、饮酒0.960（0.833,1.107）、感冒或发热2.072（1.616,2.656）、用药1.797（1.342,2.405）、糖尿病1.376（1.196,1.583）、孕前肥胖1.197（1.104,1.298）、高龄1.118（1.066,1.174）和不良生育史2.222（1.630,3.028）.结论 先心病的发生可能与孕期不良因素暴露、患病、用药、孕母年龄、孕前肥胖和不良生育史有关,应加强孕期保健,降低先心病的发病率.Objective To explore the relationship between pregnancy-related risk factors and congenital heart disease in children in order to provide scientific evidence for etiological research of congenital heart disease. Methods The studies which examined the influence factors of congenital heart disease and published between 2002-2012 were subjected to meta-analysis by using Stata software package. The odds ratio（OR） and 95% confidence interval （CI） were calculated by using heterogeneous tests,the publication bias assessed and the sensitivity analyzed. Results A total of 27 studies were finally included in the meta- analysis,including 24 949 cases and 79 828 controls. The OR values and 95o/oo CI of 10 factors associated with congenital heart disease were as follows：mental stimulation [0R=2. 977,95% CI （2. 338,3. 789）],exposure to harmful substances [OR= 1.891,95% CI （1.254,2.851）],cigarette smoking [0R=1.065,95% CI （1.015,1.117）],drinking [0R=0.960,95% CI （0. 833,1. 107）],cold or fever [OR=2. 072,95%CI （1. 616,2. 656）],medication use [OR=1. 797,95%CI （1. 342,2. 405）3, diabetes mellitus [OR= 1. 376,95% CI （1. 196,1. 583）],obesity before pregnancy [OR=1. 197,95% CI （1. 104,1. 298）],advanced age [OR=1. 118,95% CI （1. 066,1. 174）],abnormal childbearing history [OR=2. 222,95% CI （1. 630,3. 028）]. Conclusion The occurrence of congenital heart disease may be associated with exposure to harmful substances,illness,medication use, maternal age, obesity before pregnancy and abnormal childbearing history. Prenatal care should be strengthened to reduce the incidence of congenital heart disease.

关 键 词：先天性心脏病 孕期 危险因素 META分析 

分 类 号：R725.4[医药卫生—儿科]