山东省0-7岁儿童出生缺陷高危因素分析

Analysis of the high risk factor of birth defect in childhood from age 0 to 7 in Shandong province.

目的探讨山东省0-7岁儿童出生缺陷(先天性和遗传性疾病)发生率及高危因素。方法采用分层整群抽样方法,对9个示范县(市、区),18．3万名0-7岁儿童进行基线调查。采用回归性调查表法初筛可疑阳性患儿,按全国统一诊断标准查体,诊断,填表,录入微机进行统计学处理。结果 18．3万名儿童中,确诊先天性或遗传性疾病2571 名,患病率为14.03％。排前十位的出生缺陷疾病依次为,腹股沟疝和脐疝、智力低下、鞘膜积液、先天性心脏病、眼部畸形和视力障碍)、肢体畸形、脑瘫、唇裂(腭)裂、先天性耳前瘘管和聋哑。影响出生缺陷高危因素包括:妊娠早期服用镇静剂OR 9．39和激素药物OR 5．38,围产期接触农药OR 4．88和化学制剂OR 3．34,妊娠合并症OR 4,56,既往流产史 OR 4．21,围产期精神不良刺激OR 2．43及母亲多产OR 2．63等。结论母亲孕产次、妊娠合并症和围产期接触农药和化学制剂是出生缺陷发生的高危因素。

Objective： To investigate the rate and the high risk factors of birth defect （include congenital and genetic diseases） in children aged 0 to 7 in Shandong province. Methods： Stratified cluster sampling was used. A number of 183249 children aged 0 -7 were surveyed randomly in Shandong of 9 model sides （county, city or district）. Results： The incidence of childhood congenital and genetic diseases was 14. 03‰ （2571/183249）. The first to the tenth disease was inguinal hernia and umbilical hernia （n = 442）, mental retardation （ n = 317）, hydroceles （ n = 245 ）, congenital cardiopathy （ n = 243 ）, blindness and dysopia vision （ n = 233 ）, congenital extrinsic deformities （ n = 206）, cerebral palsy （ n = 202）, harelip and cleftpalate （ n = 124）, preauricular fistula （ n = 122）, and deaf - mutism （ n = 115）, respectively. The high risk factors of birth defect were multi - deliveries （ OR 2. 63）, past abortion history （ OR 4. 21 ）, gestation with complications （ OR 4. 56）, pre or post - pregnancy contacting pesticide （ OR 4. 88） or chemical preparation （OR 3.34）, mother using calmative （OR 9. 39） or hormone drugs （OR 5.38 ） in early pregnancy, and feeling nervous or doldrums （ OR 2. 43）, etc. Conclusion ： The multi - deliveries, past abortion history, gestation with complications, pre or post - pregnancy contacted pesticide or chemical preparation, used calmative or hormone drags in early pregnancy, and feeling nervous or doldrums in mother have obviously affection for birth defects.