我国南、北方神经管缺陷病因学初探

A CASE-CONTROL STUDY OF NEURAL TUBE DEFECTS IN CHINA

对１９８６～１９８８年间监测的４１３４例神经管缺陷进行了病例对照（１：１）研究。对照为在同一医院紧接畸形儿出生的一例非畸形活产儿。采用非条件Ｌｏｇｉｓｔｉｃ回归方法控制混杂因素后，发现南北方神经管缺陷的发生均与母亲孕早期接触射线、噪声、化学物、农药有关。孕早期感冒并发热或不发热（南方、北方组）、服用磺胺（北方组）、避孕药（北方组）、中草药（南方、北方组）等亦可增加神经管缺陷发生的危险性。

A total of 4 134 cases and controls were investigated to reveal the risk factors for neural tube defects(NTD),which were collected from Oct.1986 to Dec.1988 in 945 hospitals from 29 provinces of china.A control was defined as normal live birth occurring immediately before or after the birth of a NTD.Regarding the Yangtse River as a boundary,we divided the cases and controls into the south group(991 pairs) and the north group(3 143 pairs).By using the method of unconditional logistic regression for controlling confounding factors in both south and north groups,it was found that NTD were associated with the history of the mother's exposure during early pregnancy to radiation,noise,chemical substance and pesticide.The exposures to influenza,sulfa drugs,contraceptive and Chinese herbs were also found to increase the risk of NTD.