孕产期因素与发育性髋关节发育不良的相关性分析  

Correlation Analysis of Perinatal and Gestational Factors for Developmental Dysplasia of the Hip

作　　者：梁馨月[1] 张大龙[2] 李蓉[1] 王雯雯[1] 张菲菲[1] 尤志强 LIANG Xinyue;ZHANG Dalong;LI Rong(Tianjin Center for Women and Children’s Health,Tianjin City 300001)

机构地区：[1]天津市妇女儿童保健中心,300001 [2]天津市疾病预防控制中心

出　　处：《医学理论与实践》2019年第3期327-329,342,共4页The Journal of Medical Theory and Practice

摘　　要：目的:对孕产期因素与发育性婴儿髋关节发育不良(DDH)进行相关性分析,并确定危险因素,为该病的病因研究和早期预防提供依据。方法:根据Graf髋关节冠状切面超声检查法,将2009—2014年天津市妇幼卫生系统内共2 124例髋关节检查结果为异常的婴幼儿设为病例组,从系统内按照性别、年龄进行配对,采用分层抽样的方式抽取2 335名双侧髋关节均正常的婴幼儿作为对照组。通过对所有受试者母亲进行问卷调查,广泛收集影响婴幼儿DDH母体孕产期因素,并进行单因素Logistic回归分析,并进一步行二元多因素Logistic回归分析,计算OR值及其95%置信区间。结果:单因素Logistic回归分析结果显示,出生时胎龄、出生时体重、生产胎数、出生方式、喂养方式和孕期喝奶情况与DDH的发病有关(P <0. 1);二元多因素Logistic回归分析结果显示,低体重儿和高体重儿、早产儿和过期产儿以及生产胎数大于1胎都是DDH的保护因素(P <0. 05,OR <1),而剖宫产的生产方式、非母乳喂养和母体孕期偶尔喝奶或不喝奶都是DDH的危险因素(P <0. 05,OR> 1)。结论:孕期偶尔喝奶或不喝奶、剖宫产的生产方式和非母乳喂养是DDH发病的危险因素,建议孕产妇在孕期经常喝奶,在产期采用顺产的生产方式,在哺乳期采用母乳喂养,可以降低DDH的发病风险。对于第一胎女孩、正常体重儿及巨大儿DDH的发育要给予密切关注。Objective:To make correlation analysis of perinatal and gestational factors for Developmental dysplasia of the hip(DDH),and to explore risk factors of DDH for etiological research and primary prevention about DDH.Methods:A total of 2 124 infants of DDH in Tianjin children health system,diagnosed with Graf’s method,were divided into case group.2 335 infants of the system were divided into control group by stratified sampling on the basis of the gender,age of episode.A questionnaire survey was performed in all subjects to collect perinatal and gestational factors for DDH.Univariate Logistic analysis was performed firstly.Parameters with significant difference(P﹤0.1)were selected to perform binary Logistic regression analysis.OR value and 95%confidence interval were calculated.Results:Univariate Logistic regression analysis showed that gestational age,birth-weight,primiparity,delivery mode,feeding way and milk consumption during pregnancy were possibly associated with DDH(P﹤0.1).The binary Logistic regression analysis showed that low-birth-weight,high-birth-weight,premature,large for gestational age and multiparity were protective factors for DDH(P﹤0.05,OR﹤1),and never drinking milk or drinking milk occasionally during pregnancy,cesarean sections and non-breastfeeding were risk factors for DDH(P﹤0.05,OR >1).Conclusion:Never drinking milk or drinking milk occasionally during pregnancy,cesarean sections and non-breastfeeding were risk factors for DDH.High milk intake during pregnancy,spontaneous delivery and breastfeeding were encouraged to reduce the risk of DDH.First female infants,normal birth-weight and high-birth-weight need to be concerned for prevention of DDH.

关 键 词：发育性髋关节发育不良 孕产期因素 相关性分析 

分 类 号：R714.51[医药卫生—妇产科学]