出生缺陷影响因素的meta分析

A meta-analysis of risk factors of birth defects

目的:探讨出生缺陷发生的影响因素,为开展防治工作提供依据。方法:利用meta分析方法研究国内12篇关于出生缺陷发生影响因素的文献。累计病例3771例,对照31549例。结果:单因素分析中各因素及其合并比值比(OR)分别为:家族遗传史(5.11)、生育畸形史(2.94)、近亲结婚(7.69)、胎数(4.67)、产次(1.77)、胎龄(0.71)、家庭附近有污染(2.22)、孕期暴露于有害物质(4.37)、孕期感冒(2.18)、孕期发热(10.25)、孕期服药(2.98)、孕期接触宠物(3.12)、父亲吸烟(2.32)与饮酒(1.90)、常吃新鲜蔬菜(0.59)与水果(0.67);多因素分析中各因素及其合并比值比(OR)分别为:家族遗传史(2.61)、生育畸形史(2.87)、孕期服药(5.11)、孕期暴露于有害物质(4.76)和父亲吸烟(1.53)。结论:家族遗传史、生育畸形史、近亲结婚、母亲年龄、胎数、产次、家庭附近有污染、孕期暴露于有害物质、孕期感冒、孕期发热、孕期服药、孕期接触宠物、父亲吸烟与饮酒是出生缺陷发生的危险因素,胎龄、常吃新鲜蔬菜与水果是出生缺陷发生的保护因素。

Objective：To explore risk factors related to perinatal birth defects in order to provide evidence for birth defects prevention.Methods：Twelve papers were analyzed by a meta-analysis method.The cumulative cases and controls were 3 771 and 31 549,respectively.Results：The pooled odds ratio （OR） values of single-factor-analysis were as follows：family genetic history （5.11）,abnormal child-bearing history （2.94）,consanguineous marriage （7.69）,the number of pregnancy （4.67）,parity （1.77）,gestational age （0.71）,domestic contamination （2.22）,exposure to harmful substances （4.37）,catching a cold during pregnancy （2.18）,fever during pregnancy （10.25）,drug use （2.98）,pet contacting during pregnancy （3.12）,paternal smoking （2.32） and drinking（1.90）,dietary intake of fresh vegetables（0.59） and fruits （0.67）.The pooled odds ratio （OR） values of multiple-factor analysis were as follows：family genetic history （2.61）,abnormal child-bearing history （2.87）,drug use （5.11）,exposure to harmful substances （4.76）,paternal smoking （1.53）.Conclusion：The risk factors of birth defects are family genetic history and abnormal child-bearing history,consanguineous marriage,the number of pregnancy,parity,and domestic contamination,exposure to harmful substances,catching a cold and fever during pregnancy,drug use,pet contacting during pregnancy,and paternal smoking and drinking.The protective factors are the gestational age and dietary intake of fresh vegetables and fruits.