2011年上海市新生儿先天性心脏病影响因素的病例-对照研究

A Case-Control Study on Influencing Factors of Congenital Heart Disease in Neonates in Shanghai,2011

为分析2011年上海市新生儿先天性心脏病（CHD）发生情况，探讨与CHD发生有关的危险因素。研究人员采用病例对照研究方法，结合病史摘录和调查问卷，采集2011年上海市CHD患儿和非CHD对照儿童父母的孕期／孕前期的生活行为和环境暴露因素等信息。对危险因素的探索采用logistic回归进行单因素和多因素分析。

[Objective]To analyze the occurrence of congenital heart disease(CHD) among neonates in Shanghai in 2011,to explore the risk factors associated with CHD,and to provide scientific basis for preventive measures.[Methods]A case-control study of CHD was conducted,combining with medical history and questionnaire,to collect information on life style and environmental factors of their parents of 464 CHD cases and 1585 healthy neonates in Shanghai in 2011.Risk factors were determined using single-factor and multivariate logistic regression analyses.[Results]In 2011,most CHD in Shanghai were found to be atrial septal defect(29.98%),followed by patent ductus arteriosus(28.05%) and ventricular septal defect(11.03%).Multivariate logistic regression(χ2=116.53,P<0.0001) showed that multiple pregnancy,father’s age above 50 years,mothers without regular prenatal care,mothers’ experiences negative life events during pregnancy,and tobacco exposure during pregnancy were the possible risk factors(OR=22.65,4.60,1.31,2.52,and 1.62,respectively).[Conclusion]Choosing the best childbearing age,avoiding bad habits,maintaining mental health,strengthening health care,and taking regular prenatal care during pregnancy would help reduce the risk of CHD in neonates.