上海某区出生缺陷危险因素的病例对照研究

Risk factors of birth defects in a district of Shanghai: a case-control study

目的:探讨上海某区主要出生缺陷的危险因素,为出生缺陷综合防治提供参考依据。方法:采用1∶2匹配病例对照研究方法,选取孕满28周至产后42天首次确诊为出生缺陷儿(包括死产、死胎)137例(病例组)和同期出生相差<1个月正常婴儿的母亲274例为对照组,探讨出生缺陷发生的危险因素。结果:出生缺陷儿中先天性心脏病和外耳畸形各占30.7%,其次是血管瘤和多指(趾)分别占10.9%和8.8%。多因素Logistic回归分析提示,孕前疾病史、孕期疾病史、居所近高速道路、污染行业工作史、饮酒是本区出生缺陷发生的高危因素。结论:减少和控制围孕期危险因素是预防出生缺陷的重要环节。

Objective： To explore the main risk factors of birth defects in a district of Shanghai,provide reference for comprehensive prevention and treatment of birth defects. Methods： A 1∶ 2 matched case- control study was conducted,137 infants（ including stillbirth） diagnosed as birth defects for the first time from the 28 th gestational weeks to 42 th days after birth were selected as case group,while274 normal infants during the same period were selected as control group; the difference of birth time of the infants between the two groups was less than one month; the risk factors of birth defects were analyzed. Results： The proportions of congenital heart disease and external ear deformity were 30. 7%,respectively,followed by hemangioma（ 10. 9%） and polydactylism（ 8. 8%）; multivariate logistic regression analysis indicated that medical history of diseases before pregnancy,medical history of diseases during pregnancy,living near highways,work experience in polluting industries,and wine drinking were high risk factors of birth defects. Conclusion： Reducing and controlling risk factors during periconceptional period are important for prevention of birth defects.