父母围孕期吸烟和饮酒及其交互作用与子代先天性心脏病关联的病例对照研究  

A case-control study on the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease in offspring

作　　者：李柳萱 罗曼君 阮霄睿 刘涵君 唐嘉鹏 杨贵红[2] 秦家碧 LI Liu-Xuan;LUO Man-Jun;RUAN Xiao-Rui;LIU Han-Jun;TANG Jia-Peng;YANG Gui-Hong;QIN Jia-Bi(Department of Epidemiology and Health Statistics,Xiangya School of Public Health,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅公共卫生学院流行病与卫生统计学系,湖南长沙410013 [2]湖南省儿童医院心胸外科,湖南长沙410007

出　　处：《中国当代儿科杂志》2024年第10期1019-1026,共8页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金项目(81803313、82073653);湖南省杰出青年基金项目(2022JJ1087)。

摘　　要：目的探讨父母围孕期吸烟、饮酒及交互作用与子代先天性心脏病(congenital heart disease,CHD)的关联。方法招募0~1岁单纯性CHD患儿(n=683)父母为病例组,0~1岁健康儿童(n=740)父母作为对照组,开展病例对照研究,并采用调查问卷收集围孕期相关暴露信息。采用多因素logistic回归分析和倾向性评分匹配方法调控相关混杂因素后探讨父母围孕期吸烟、饮酒及其交互作用与CHD的关联,并评估吸烟和饮酒的叠加效应对CHD的影响。结果围孕期母亲主动吸烟(OR=2.91,95%CI:1.60~5.30)、被动吸烟(OR=1.94,95%CI:1.56~2.42)和饮酒(OR=2.59,95%CI:1.89~3.54)及父亲吸烟(OR=1.52;95%CI:1.22~1.90)和饮酒(OR=1.48,95%CI:1.19~1.84)与子代CHD风险增加有关(P<0.05)。父母围孕期吸烟和饮酒在子代CHD发生风险中不存在交互作用(P>0.05)。父母围孕期吸烟饮酒行为存在越多,子代发生CHD的风险越大(OR=1.50,95%CI:1.36~1.65)。结论父母围孕期吸烟及饮酒与子代CHD发生有关,且对CHD风险存在叠加效应,提示围孕期应减少烟草及酒精暴露以降低CHD的发生。Objective To explore the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease(CHD)in offspring.Methods The parents of children with simple CHD aged 0 to 1 year(n=683)were recruited as the case group,while the parents of healthy children aged 0 to 1 year(n=740)served as the control group.A case-control study was conducted,and a questionnaire was used to collect information on perinatal exposures.After controlling for relevant confounding factors using multivariate logistic regression analysis and propensity score matching,the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with CHD were examined,as well as the cumulative effects of smoking and drinking on CHD risk.Results Maternal active smoking(OR=2.91,95%CI:1.60-5.30),passive smoking(OR=1.94,95%CI:1.56-2.42),and alcohol consumption(OR=2.59,95%CI:1.89-3.54),as well as paternal smoking(OR=1.52;95%CI:1.22-1.90)and drinking(OR=1.48,95%CI:1.19-1.84),were associated with an increased risk of CHD in offspring.There was no interaction between parental smoking and drinking behaviors during the periconceptional period concerning the risk of CHD in offspring(P>0.05).The more parents'smoking and drinking behaviors during the perinatal pregnancy,the higher the risk of CHD in their offspring(OR=1.50,95%CI:1.36-1.65).Conclusions Parental smoking and alcohol consumption during the periconceptional period are associated with the occurrence of CHD in offspring,and there is a cumulative effect on CHD risk,suggesting that reducing tobacco and alcohol exposure during the periconceptional period may lower the incidence of CHD.

关 键 词：先天性心脏病 吸烟 饮酒 交互作用 病例对照研究 子代 

分 类 号：R715.3[医药卫生—妇产科学] R725.4[医药卫生—临床医学]