神经管缺陷高发区母亲相关行为因素研究

Research on mother's behaviour factors in areas with high incidence of NTDs

目的在对预防出生儿神经管缺陷(neural tube defects,NTDs)实施以叶酸作为有效干预的情况下,研究其仍然高发的影响因素。方法采用1∶1配比的病例对照研究方法,选取生育过NTDs患儿的210例产妇组成病例组,从同年、同地市、同医院生育健康儿的产妇中选取对照。针对上述研究对象收集母亲围孕期相关行为因素并进行分析。结果孕期被动吸烟(OR=11.203,P<0.001)、孕期服药(OR=10.137,P=0.039)、孕前配偶接触有害物质(OR=6.231,P=0.003)为NTDs的危险因素,计划怀孕(OR=0.265,P=0.008)、服用叶酸(OR=0.158,P<0.001)、孕期精神状态好(OR=0.434,P<0.001)为保护因素。结论被动吸烟、孕期服药、配偶在妻子孕前接触有害物质可使NTDs发生的危险性增加,而计划怀孕、服用叶酸以及孕期精神状态好可降低NTDs的发生率。

Objective To investigate the related factors contributing to high incidence of NTDs （neural tube de- fects） after the effective intervention with folic acid. Methods A 1： 1 matched case-control study was conducted. Each case was matched with control on areas, hospital and year of birth. Then information on related factors was collected and an- alyzed during periconceptional period. Results Passive smoking （ OR = 11. 203, P〈 0. 001 ）, drugs during pregnancy （OR= 10. 137, P = 0. 039）, husband exposure to harmful substances pre-pregnancy （OR=6.231, P = 0. 003 ） were risk factors for NTDs, while planned pregnancy （ OR=O. 265,P=0. 008）, adequate folic acid （ OR=O. 158,P〈0. 001 ）, a good mental state during pregnancy （ OR = 0. 434, P〈0. 001 ） were protective factors. Conclusions Passive smoking, drugs during pregnancy, the husband exposure to harmful substances pre-pregnancy can increase the risk of NTDs while the planned pregnancy, sufficient folic acid, and a good mental state during pregnancy can reduce the incidence of NTDs.