近5年我国出生缺陷非遗传因素研究现状的Meta分析

Meta-analysis of research status on non-genetic influential factors of perinatal birth defects in China during recent five years

目的 分析近5年我国围产儿出生缺陷发生非遗传影响因素的研究现状,为开展工作提供依据。方法 利用meta分析方法研究近5年国内16篇关于出生缺陷发生影响因素的文献。累计病例4922例,对照29144例。根据齐性检验结果计算各危险因素合并比值比（odds ratio,OR）及其95%可信区间（95%confidence interval CI,95%CI）模型。结果 9个研究因素合并OR值及95%CI分别为：孕早期接触化学毒物6.41（2.33~18.55）,孕期接触有害物理因素4.76（2.79~8.04）,孕早期接触宠物3.96（1.26~12.18）,孕早期患病3.96（1.21~8.87）,孕早期用药8.08（1.59~18.39）,孕期负性精神刺激1.98（1.29~5.46）,孕期主动或被动吸烟5.80（1.09~9.48）,孕期摄入足量水果蔬菜或优质蛋白0.67（0.53~0.84）,家庭月人均收入水平明显高于当地0.64（0.44~0.99）。结论 孕早期接触有害化学、物理、生物因素,以及负性精神刺激是出生缺陷发生的非遗传危险因素。孕期摄入足量水果蔬菜或优质蛋白、家庭收入高是出生缺陷发生的非遗传保护因素。近5年我国围产儿出生缺陷发生非遗传影响因素的研究缺乏新进展,急需进一步深入研究。

Objective To analysis the research status on non-genetic influential factors related to perinatal birth de- fects in Chinese population during recent five years and thus provide evidence for decision-making on perinatal birth defects prevention. Method The results about the influential factors of perinatal birth defects in 16 papers were analyzed by meta-analysis method. The cumulative cases and controls were 4922 and 29144 respectively. The calculation methods of the merged odds ratio（OR） and 95% confidence interval（CI） were determined according to the homogeneity test. Result The pooled OR values and 95 % CI were as follows：exposure to damage chemicals in early pregnancy 6.41 （ 2.33 - 18.55 ） , exposure to harmful physical factors during pregnancy 4.76 （ 2.79 - 8.04 ）, illness during pregnancy 3.96（ 1.21 - 8.87 ） , medicine use in early pregnancy 8.08 （ 1.59 - 18.39 ） , pet exposure during pregnancy 3.96 （ 1.26 - 12.18 ）, negative spiritual stimulus 1.98 （ I. 29 - 5.46）, active or passive smoking during pregnancy 5.80 （ 1.09 - 9.48 ） , dietary intake of fresh fruits, vegetables and high-quality protein 0.67 （ 0.53 - 0.84 ）, high household income 0.64 （ 0.44 - 0.99 ）. Conclusion The main non-genetic risk factors influencing the incidence of birth defects in China are exposure to harmful chemical, physical and biological factors during pregnant and negative spiritual stimulus. The protective factors are dietary intake of fresh fruits, vegetables and high-quality protein and high household income. The research on non-genetic influential factors related to perinatal birth defects in Chinese population during recent five years lacks of new progress, need ing further study.