孕早期环境因素对儿童先天性心脏病的影响  

Effect of environmental factors on congenital heart disease of children during the first trimester of pregnancy

作　　者：李玉哲[1] 王晨虹[1] 赖彩芹 杨虹[1] 袁辉[1] 刘力华[1] 王洁[1] 杨晓红[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院产科,广东深圳518000

出　　处：《中国妇幼保健》2015年第5期742-744,共3页Maternal and Child Health Care of China

基　　金：2013年深圳市科技研发资金知识创新计划基础研究项目〔JCYJ20130402094134981〕

摘　　要：目的：探讨孕早期环境因素对儿童先天性心脏病（CHD）的影响。方法：收集2011年6月-2013年12月在深圳市妇幼保健院出生的汉族CHD患儿100例作为病例组,按照配对（1∶1）病例对照研究选取同期同医院同民族体检正常的儿童100例作为对照组,通过问卷调查及多因素Logistic回归分析方法,分析CHD可能的危险因素。结果：病例组患儿CHD的主要类型有室间隔缺损51例（51.0%）、房间隔缺损32例（32.0%）、动脉导管未关闭12例（12.0%）、其他5例（5.0%）。应用卡方检验筛选其中孕前6个月慢性病史、严重早孕反应、孕早期感冒、孕妇职业危险因素接触史、孕妇异常生育史、孕妇流产史、孕早期服药史、母亲被动吸烟、丈夫职业危险因素接触史、丈夫饮酒史、孕前补充维生素和补充微量元素等因素,两组间差异具有统计学意义（P〈0.05）;多因素Logistic回归分析发现,孕前补充维生素和微量元素与CHD发生呈现负相关关系;孕前6个月慢性病史、孕妇职业危险因素接触史、孕早期感冒、孕妇异常生育史、母亲被动吸烟和丈夫职业危险因素接触史与CHD发生呈现正相关关系。结论：儿童发生CHD与父母双方的某些习惯或者孕前的某些状况都有关系,应加强父母双方怀孕的整个过程的健康教育,保健服务以及减少对危险因素接触,从而减少和预防CHD的发生。Objective： To explore the effect of environmental factors on congenital heart disease （CHD） of children during the first trimester of pregnancy. Methods： One hundred CHD children of Han nationality born in this hospital from June 2011 to December 2013 were selected as case group, 100 normal children of Han nationality after physical examination in the same hospital and during the same period were selected as control group. The probable risk factors of CHD were analyzed by questionnaire survey and multivariate Logistic regression analysis. Results： The main types of CHD in case group included ventricular septal defect （51 children, 51.0% ）, atrial septal defect （32 children, 32. 0% ）, patent ductus arteriosus （ 12 children, 12. 0% ） and others （5 children, 5.0% ） . There were statistically signifi- cant differences in the history of chronic diseases within 6 months before pregnancy, severe morning sickness, catching a cold during the first trimester of pregnancy, contact history of maternal occupational risk factors, history of abnormal childbirth, history of abortion, history of taking medicine during the first trimester of pregnancy, maternal passive smoking, contact history of paternal occupational risk factors, history of paternal drinking, supplementation of vitamins and trace elements before pregnancy between the two groups （P 〈 0. 05） ; multivariate Logistic regression analysis found that supplementation of vitamins and trace elements before pregnancy was negatively correlated with the occurrence of CHD; the history of chronic diseases within 6 months before pregnancy, contact history of maternal occupational risk factors, catching a cold during the first trimester of pregnancy, history of abnormal childbirth, maternal passive smoking and contact history of paternal occupational risk factors were positively correlated with the occurrence of CHD. Conclusion： The occurrence of CHD in children is correlated with some habits of parents and progestational situations ; health edu

关 键 词：孕早期 环境因素 儿童先天性心脏病 

分 类 号：R715.3[医药卫生—妇产科学]