孕早期非遗传因素与先天性心脏病的病例对照研究  

A case- control study on the relationship between non- genetic factors in early pregnancy and congenital heart disease

作　　者：胡卉[1] 刘珍[2] 李小洪[1,2] 李娜娜[2] 邓莹[2] 邓奎[1] 朱军[1] 袁萍[3] 

机构地区：[1]四川大学华西第二医院中国出生缺陷监测中心 [2]四川大学华西第二医院出生缺陷分子流行病学实验室 [3]四川大学华西公共卫生学院流行病与卫生统计教研室,四川成都610041

出　　处：《中国妇幼保健》2014年第21期3420-3424,共5页Maternal and Child Health Care of China

基　　金：国家重点基础研究发展计划(973计划)(2010CB529501);国家"十二五"科技支撑项目(2014BAI06B01);国家自然科学基金(81273086)

摘　　要：目的：了解孕妇孕早期非遗传因素与先天性心脏病（CHD）之间的关系，为CHD病因防治提供线索。方法：收集2010年2月～2012年10月在深圳、郑州、福州和武汉4所三级医院产前诊断CHD胎儿的孕妇为病例组，采用1：1配对病例对照研究，分析364对CHD胎儿的父母与对照组父母的非遗传暴露因素，对CHD可能的暴露因素进行风险评估。结果：怀孕前后遭遇负性生活事件（OR=2．161，95％C1：1．265～3．692）、孕早期感冒（OR=1．905，95％CI：1．197—3．032）及母亲家或单位附近有工厂（OR=1．825，95％C1：1．032—3．226）3个因素是后代发生CHD的危险因素，怀孕前后补充叶酸（OR=0．462，95％CI：0．265—0．805）及补充复合维生素（OR=0．432，95％CI：0．252—0．741）2个因素是后代发生CHD的保护因素。结论：母亲怀孕前后遭遇负性事件、孕早期感冒及母亲家或单位附近有工厂可能增加后代发生CHD的危险，而怀孕前后补充叶酸及复合维生素可能降低后代发生CHD的危险。Objective： To understand non -genetic factors in early pregnancy and congenital heart disease （CHD）, provide clues for preventing and treating etiological factors of CHD. Methods： The pregnant women whose fetuses were diagnosed as CHD during prenatal examination in four tertiary hospitals of Shenzhen city, Zhengzhou city and Wuhan city from February 2010 to October 2012 were collected as case group ; a 1 ： 1 matched case - control study was performed to analyze the non - genetic exposure factors among the parents in case group （364 couples） and control group （364 couples）, risk assessment of probable exposure factors of fetal CHD was conducted. Results： The risk factors of fetal CHD included maternal negative life events before and after conception （ OR = 2. 161, 95% CI： 1. 265 - 3. 692）, flu in early pregnancy （ OR = 1. 905, 95% CI： 1. 197 - 3. 032） and factories near maternal home or work unit （ OR = 1. 825, 95% CI： 1. 032 - 3. 226） ; the protective factors of fetal CHD included folic acid supplement before and after conception （ OR = 0. 462, 95% CI： O. 265 - 0. 805 ） and multivitamin supplement before and after conception （ OR = 0. 432, 95 % CI： 0. 252 - 0. 741 ） . Conclusion： Maternal negative life events before and after conception, flu in early pregnancy and factories near maternal home or work unit may raise the risk of fetal CHD, while folic acid and multivitamin supplement before and after conception may reduce the risk of fetal CHD.

关 键 词：先天性心脏病 孕早期 病例对照研究 非遗传因素 

分 类 号：R715.5[医药卫生—妇产科学]