中国部分地区胎婴儿尿道下裂的相关因素分析

Factors associated with hypospadias in male births in China

目的分析尿道下裂相关因素，探索尿道下裂的病因。方法对江苏、浙江和河北省的27个县（市）以人群为基础的出生缺陷和围生保健监测系统中，1993年1月1日～2000年12月31日孕20周及以上到出生后42d的590042名男性胎婴儿的相关资料进行单因素和多因素Logistic回归分析。结果单因素分析发现家庭居住在南方、城市地区，母亲职业非农民和乡镇企业工人、母亲高中及以上文化程度，父亲职业非农民和乡镇企业工人，双胎或多胎，出生体重〈2500g、足月低出生体重和早产是尿道下裂的相关因素（P〈0．05）。多因素Logistic回归分析发现，南方地区尿道下裂的患病率高于北方（OR=2．051，95％CI：1．296～3．248），足月低出生体重（OR=20．338，95％CI：13．667～30．265）和早产（OR=2．710，95％CI：1．817—4．042）与尿道下裂的关联性仍有统计学意义。结论足月低出生体重和早产与尿道下裂相关联；应重视低出生体重和早产的预防，并开展中国南方地区尿道下裂病因研究和预防工作。

Objective To determine the factors associated with hypospadias in male births in some areas of China. Methods The data was obtained from records of birth defects surveillance system in 27 cities and counties in Jiangsu, Zhejiang and Hebei Provinces in China during January 1 , 1993 and December 31, 2000. The study population included all male live births, fetal deaths and still births with gestational age of 20 or more weeks. Results The results of univariate analysis were ： living in southern areas or urban areas, the maternal occupation were not farmers or workers in a township factory, the education of the mother were higher than senior middle school, the paternal occupation were not farmers or workers in a township factory, twins or triplets, low birthweight, small for gestational age and preterm were the factors associated with the prevalence of hypospdias in male births （ P 〈 0. 05 ）. The results after adjusted the confounding effect with multivariate logistic model were： living in southern areas （OR = 2. 051, 95 % CI： 1. 296 - 3. 248） , small for gestation age （ OR ：20. 338, 95 % CI： 13. 667 -30. 265） and preterm （ OR =2. 710, 95 % CI： 1. 817 - 4. 042 ） were the factors associated with the prevalence of hypospdias in male births. Conclusions More researches need to focus on the etiology and prevention of hypospadias in southern area in China, and small for gestation age and preterm may share the cauases with hypospadias.