单纯性尿道下裂发病影响因素病例对照研究

Risk factors of isolated hypospadias:a case-control study

目的了解单纯性尿道下裂发病的影响因素,为预防和减少单纯性尿道下裂的发病提供理论依据。方法采用以医院为基础的1:1病例对照研究方法对2010年5月—2011年4月在中国医科大学附属盛京医院住院的85例先天尿道下裂患儿及同期住院的85例其他疾病患儿父母进行面访调查。结果病例组父亲高中及以上文化程度、母亲高中及以上文化程度、胎儿低出生体重、母亲孕前月经不调、孕前用药、孕早期摄入蛋白质、孕早期服用叶酸、孕期出现异常情况、孕前及孕早期接触化学物及父亲职业接触化学物和家庭从事农牧业生产的比例分别为23.5%、28.2%、32.9%、28.2%、32.9%、47.1%、20.0%、50.6%、42.4%、68.2%和49.4%;对照组分别为50.6%、47.1%、5.9%、15.3%、18.2%、63.5%、36.5%、25.9%、16.5%、42.4%和32.9%,差异均有统计学意义(P<0.05);多因素Lo-gistic回归分析结果表明,胎儿低出生体重(OR=2.12,95%CI=1.18,4.14)、母亲孕期出现异常情况和孕前(OR=3.09,95%CI=1.41,6.80)及孕早期接触化学物是单纯性尿道下裂发病的危险因素;父亲高中及以上文化程度(OR=2.12,95%CI=1.18,4.14)是单纯性尿道下裂发病的保护因素。结论胎儿低出生体重、母亲孕期出现异常情况和母亲孕前及孕早期接触化学物的儿童更易患单纯性尿道下裂。

Objective To explore the risk factors of isolated hypospadias and to provide evidence for decreasing the incidence of the disease.Methods A hospital-based case-control study was conducted among 85 hypospadias patients and 85 non-hypospadias patients selected from Shengjing Affiliated Hospital of China Medical University from May 2010 to April 2011.The parents of the subjects were interviewed face-to-face with a questionnaire.Logistic regression model was used for univariate and multivariate analyses with SPSS17.0 software to estimate the odds ratios（OR）and 95 percent confidence interval（95%CI）.Results There were significant differences in the ratios of father with high school or higher education（23.5% vs 50.6%）,the mother with high school or higher education（28.2% vs 47.1%）,low birth weight（32.9% vs 5.9%）,the mother with irregular menstruation before pregnancy（48.2% vs 15.3%）,medication of the mother before pregnancy（32.9% vs 18.2%）,intake of protein of the mother in early pregnancy,folic acid intake of the mother in early pregnancy（20.0% vs 36.5%）,the mother with abnormal conditions during pregnancy（50.6% vs 25.9%）,materal chemicals exposure before pregnancy and during early pregnancy（42.4% vs 16.5%）,paternal occupational exposure to chemicals（68.2% vs 42.4%）,and families engaged in agriculture and stockbreeding（49.4% vs 32.9%） between the case and control groups（P0.05 for all）.Multivariate analyses showed statistically significant associations of the 4 indexes with isolated hypospadias.Maternal exposure to chemicals during progestational time and first-trimester（OR=3.09,95% CI：1.41-7.629）,abnormal conditions during pregnancy（OR=2.12,95% CI：1.18-4.14）,father with high school or higher education education（OR=0.34,95% CI：0.17-0.72）,and low birth weight（OR=5.28,95% CI：1.79-15.57） were the risk factors of isolated hypospadias.Conclusion Maternal exposure to chemicals in first-trimester,pregnancy with abnormal conditions,and low birth weight are the risk factors of isolated hypospadias.