胎儿先天性心脏病影响因素的病例-对照研究

Case-control study on influencing factors in antenatal congenital heart disease

目的探讨胎儿先天性心脏病的主要影响因素,为制定相应的干预措施提供参考依据。方法采用以医院为基础的病例对照研究方法,对95名先天性心脏病胎儿和262名正常胎儿的父母进行面访式问卷调查,应用单因素和多因素非条件Logistic回归分析,筛选胎儿先天性心脏病的影响因素。结果多因素分析结果表明,家庭人均月收入高(OR=0.17,95%CI:0.08-0.37)、母亲孕早期每日补充叶酸(OR=0.27,95%CI:0.13-0.56)、体育锻炼(OR=0.13,95%CI:0.06-0.31)、父亲在母亲孕前饮酒(OR=0.14,95%CI:0.07-0.31)及体育锻炼(OR=0.08,95%CI:0.03-0.17)可减少胎儿患先天性心脏病的风险;而母亲孕早期感冒(OR=3.32;95%CI:1.45-6.80)、接触噪音(OR=3.26,95%CI:1.42-7.46)、使用电脑(OR=3.22,95%CI:1.54-6.76)则可能增加胎儿患先天性心脏病的风险。结论胎儿先天性心脏病的发生可能与父母的经济水平、健康状况、生活方式等有关,应采取综合性措施对相关因素进行干预,以减少胎儿先天性心脏病的发生。

Objective：To explore the major influencing factors of antenatal congenital heart disease. Methods：A hospitalbased case-control study with parents of 95 fetus with congenital heart disease and 262 normal fetuses was conducted. Singlefactor and multiple-factor non-conditional logistic regression analysis were performed to screen the influencing factors of antenatal congenital heart disease. Results：The multiple-factor logistic regression analysis showed that the high-income per head（OR=0.17,95% CI：0.08-0.37）,daily supplementation of folic acid in early pregnancy（OR=0.27,95% CI：0.13-0.56）and mother who exercised（OR=0.13,95% CI：0.06-0.31）,father′s drinking before his wife pregnancy（OR=0.14,95% CI：0.07-0.31）and father who exercised（OR=0.08,95% CI：0.03-0.17）might reduce the risk of congenital heart disease. On the contrary,mother getting cold in early pregnancy（OR=3.32;95% CI：1.45-6.80）,noise exposure（OR=3.26,95% CI：1.42-7.46）,using computer（OR=3.22,95% CI：1.54-6.76）might increase the risk of congenital heart disease. Conclusion：The occurrence of antenatal congenital heart disease might be associated with economic level,health status,life style of parents. Hence,comprehensive measures of intervention on related factors should be taken to reduce the incidence of congenital heart disease.