山西省新生儿神经管缺陷的病例对照分析  

A case-control analysis of neonatal neural tube defects in Shanxi Province

作　　者：党文珊 张雪娟[1] DANG Wen-shan;ZHANG Xue-juan(Shanxi Medical Universily,Taiypuan,Shanxi 030001,China)

机构地区：[1]山西医科大学,山西太原030001

出　　处：《现代预防医学》2020年第23期4281-4284,4360,共5页Modern Preventive Medicine

基　　金：山西省卫生和计划生育委员会资助项目(2014113)。

摘　　要：目的探讨孕早期因素暴露与神经管缺陷发生的关系。方法选择2010-2014年山西省"削峰工程"各区县监测医院分娩或妇幼保健机构登记的生育神经管缺陷患儿的产妇411例纳入病例组,同时按照1∶1匹配选择同期分娩正常儿的411例产妇作为对照组进行问卷调查。采用单因素和多因素条件logistic回归模型分析孕早期各因素暴露与神经管缺陷的关系。结果多因素logistic回归分析显示,单胎、怀孕前后服用抗生素、服用其它药物、食用酸菜频次越高、电脑前工作时间越长、生病是新生儿神经管缺陷(neural tube defects,NTDs)的危险因素,OR(95%CI)分别为7.506(1.979~28.473)、8.817(1.036~75.065)、3.976(1.297~12.186)、0.780(0.618~0.986)、1.491(1.138~1.955)、1.971(1.357~2.862);接受婚前孕前指导、食用肉类及海产品频次越高、服用叶酸、保胎药是新生儿NTDs的保护因素,OR(95%CI)分别为0.642(0.459~0.898)、1.380(1.128~1.687)、0.334(0.234~0.476)、0.597(0.407~0.875)。结论加强对备孕和孕早期妇女的健康教育和指导,及时增补叶酸来降低生育神经管缺陷患儿的风险。Objective To explore the relationship between factors exposure in early pregnancy and neonatal neural tube defects.Methods From 2010 to 2014,411 cases of neural tube defects in childbearing children registered in childbirth or maternal and child health institutions of the district-and county-level monitoring hospitals of the"Pearl Reduction Project"in Shanxi Province were selected into the case group.At the same time,411 parturients with normal childbirth delivery during the same period were selected as the control groupfor questionnaire surveyaccording to 1∶1 matching method.Univariate and multifactorial conditional logistic regression models were used to analyze the relationship between factors exposure and neural tube defects in early pregnancy.Results Multivariate logistic regression analysis showed that singleton,taking antibiotics before and after pregnancy,taking other drugs,eating sauerkraut more frequently,working longer in front of computer and illness were the risk factors of neonatal neural tube defects(NTDs),OR(95%CI)were 7.506(1.979-28.473),8.817(1.036-75.065),3.976(1.297-12.186),0.780(0.618-0.986),1.491(1.138-1.955),1.971(1.357-2.862),respectively.Receiving the premarital and pre-pregnancy guidance,eating meat and seafood more frequently,taking folic acid and fetal medicine were the protective factors of neonatal NTDs,OR(95%CI)were 0.642(0.459-0.898),1.380(1.128-1.687),0.334(0.234-0.476)and 0.597(0.407-0.875),respectively.Conclusion Strengthening health education and guidance for women preparing for pregnancy and early pregnant women,and supplement folic acid in time can reduce the risk of children with fertility neural tube defects.

关 键 词：NTDS 孕妇 病例对照 

分 类 号：R179[医药卫生—妇幼卫生保健] R748[医药卫生—公共卫生与预防医学]