丽水市出生缺陷影响因素的病例对照研究  

The case-control study of influencing factors for birth defects in Lishui

作　　者：张亚丽[1] 蓝菊红[1] 吕卓超[1] 肖丽华 

机构地区：[1]丽水市中心医院新生儿科,浙江丽水323000 [2]丽水市妇幼保健院保健部,浙江丽水323000

出　　处：《温州医科大学学报》2017年第1期56-60,共5页Journal of Wenzhou Medical University

基　　金：丽水市科技局公益性项目(2013JYZB26)

摘　　要：目的:探讨丽水市出生缺陷(BD)的影响因素,为BD干预提供科学依据。方法:采用1:3配对病例对照研究,对2013年10月1日-2015年9月30日丽水市8家BD监测医院出生的妊娠满28周至出生后7 d诊断的601例BD患儿的产妇、1 803例正常新生儿的产妇进行回顾性调查,采用多因素logistic回归分析筛选BD的危险因素。结果:丽水市2年来平均BD发生率为2.979%,前5位BD依次为先天性心脏病、多指/趾、总唇裂(包括唇裂、腭裂及唇裂并腭裂)、并指/趾、小/无耳。对单因素logistic回归分析可能引起BD有统计学意义的因素再进行多因素logistic回归分析显示,母亲年龄(OR=3.752,95%CI:1.247-11.293,P=0.019)、孕早期健康情况(OR=2.997,95%CI:1.084-8.287,P=0.034)、孕期吸烟或被动吸烟(OR=2.205,95%CI:1.088~4.470,P=0.028)、孕期接触有害物质(OR=3.582,95%CI:2.071-4.983,P=0.047)及孕期化妆、染指甲、染发(OR=3.659,95%CI:2.064-6.488,P<0.001)是BD的危险因素。结论:母亲年龄、孕早期健康情况、孕期吸烟或被动吸烟、孕期接触有害物质及孕期化妆、染指甲、染发是丽水市BD的危险因素。Objective： To investigate the risk factors of birth defects in Lishui city, and to provide scientific evidence for intervention. Methods： A 1：3 case-control study was conducted, 601 mothers of infants with birth defects and 1803 controls were investigated retrospectively. Risk factors were analyzed by multivariate Logistic regression. Results： The incidence of birth defects was 29.79‰, the former five types of birth defects were congenital heart disease, polydactyly, cleft lip, syndactyly and, microtia. Logistic regression showed that maternal age（OR=3.752, 95%CI： 1.247-11.293, P=0.019）, the health condition in the first trimester of pregnancy（OR= 2.997, 95%CI： 1.084-8.287, P=0.034）, smoking or passive smoking during pregnancy（OR=2.205, 95%CI： 1.088-4.470, P=0.028）, exposure to toxic factors during pregnancy（OR=3.582, 95%CI： 2.071-4.983, P=0.047）, and face-painting, dying fingernails and dying hair in pregnancy（OR=3.659, 95%CI： 2.064-6.488, P〈0.001） were the risk factors. Conclusion： Maternal age, the health condition in the first trimester of pregnancy, smoking or passive smoking during pregnancy, exposure to toxic factors in pregnancy, and face-painting, dying fingernails and dying the hair in pregnancy are the risk factors of birth defects.

关 键 词：先天畸形 围产期 病例对照研究 危险因素 

分 类 号：R714.7[医药卫生—妇产科学]