“5·12”地震后绵阳市新生儿先天性心脏病发病率及危险因素分析

Incidence of Congenital Heart Disease in Neonates and Its Risk Factors in Mianyang after“ 5·12” Earthquake

目的了解绵阳地区"5·12"地震后新生儿先天性心脏病(CHD)发病情况,探索可能的危险因素。方法采用心脏听诊、呼吸评定、血氧饱和度测定和心脏彩色多普勒超声对绵阳地区2011年12月-2012年12月出生的5 536例新生儿行CHD筛查,对确诊病例采用病例对照研究方法进行分析。结果共筛查出CHD患儿65例,其发病率为11.74‰。发病前3位依次是室间隔缺损、房间隔缺损和动脉导管未闭。CHD发生的可能危险因素依次为:CHD家族史、母孕早期感染史、母孕期用药及饮酒史、高龄产妇和父母吸烟史,而父母地震经历史未显示与CHD相关。结论父母地震经历与CHD的发生无关。孕前加强相关健康知识宣教、避免或减少相关危险因素暴露可降低CHD发病风险。新生儿时期CHD筛查可早期发现CHD,并为后续的随访干预提供宝贵时机,降低病死率,提高患儿生命质量。

Objective To comprehend the incidence of and to search for the possible risk factors for neonatal congenital heart disease （CHD） in Mianyang after ＂5 · 12＂ Earthquake. Methods CHD screening was performed on 5 536 neonates born between December 2011 and December 2012 by cardiac auscultation, respiration evaluation, blood oxygen saturation determination and color doppler flow imaging. Case control study was applied to study the diagnosed cases of CHD. Results Sixty-five cases of CHD were found during the screening, and the incidence was 11.74‰. The most common CHD was ventricular septal defect, followed by atrial septum defect and patent ductus arteriosus. Possible risk factors were listed in order of their risks were as follows： family history of CHD, infection history in the early period of pregnancy, drug and alcohol history during pregnancy, and aged pregnancy and smoking history of the parents. However, earthquake experience history of parents was not correlated with CHD incidence. Conclusions Earthquake experience of parents is not correlated with CHD incidence. Enforcing health education for women before gestation, and avoiding or decreasing risk factors exposure can reduce the risk of CHD. CHD screening for neonates can detect CHD as early as possible, which is helpful for intervention during the follow-up, reduction of fatality, and improvement of neonates＇ quality of life.