我国出生缺陷影响因素的Meta分析

Risk factors of birth defects in China:a Meta analysis

目的探讨影响我国出生缺陷发生的主要危险因素,为制定最佳预防控制决策、实行有效的干预措施提供科学依据。方法利用Meta分析方法综合分析国内关于出生缺陷发病危险因素的研究文献21篇,累计病例6 112例,对照15 741例。据纳入与排除标准进行筛选,由异质性检验结果决定采用固定或随机效应模型,并对合并结果进行χ2检验。结果单因素分析的主要合并结果 OR值为:先天畸形家族史36.22,孕早期患感染性疾病5.62,孕早期接触化学制剂4.19,父亲吸烟3.89,孕期接触镇静药3.19,妊娠并发症2.94,孕期多食高蛋白食物0.37;多因素分析的主要合并结果OR值为:孕早期感染病毒7.65,孕期精神状态差5.44,孕早期发热4.70,妊娠早期接触化学毒物3.90,流产史3.59,孕期补充复合维生素0.45。结论影响我国出生缺陷发生的主要危险因素为先天畸形家族史、孕早期患感染性疾病、孕早期接触化学制剂、父亲吸烟、妊娠并发症;出生缺陷的保护因素为孕期多食高蛋白食物、孕期补充复合维生素和服用叶酸。

Objective To explore the main risk factors related to birth defects to provide the scientific basis for making the best prevention policy and implementing the effective interventions. Methods Totally 21 domestic research articles on the risk factors of birth defects were comprehensively analyzed by the meta.analysis method,including accumulated 6 112 patients and 15 741 control cases. The articles were screened preliminarily according to inclusion and exclusion standard, and then the fixed and random effects model were selected according to the homogeneity test. The merged results were performed the chi-square test. Results The main merged results OR values of single-factor-analysis were as follows ： the family history of birth defects 36.22, early pregnant in- fectious disease 5.62, early pregnancy exposure to chemicals 4.19, paternal smoking 3.89, contact sedatives during pregnancy 3.19, pregnancy complication 2.94,high protein food during pregnancy 0.37 ;the main merged results OR values of multiple-factor-analysis were as follows：early pregnancy infectious disease 7.65, poor prenatal mental state 5.44,early pregnancy fever 4.70,early preg- nancy exposure to toxic chemical 3.90,history of abortion 3.59, supplement of multivitamin during pregnancy 0.45. Conclusion The main risk factors of birth defects in our country are family history of birth defects, early pregnancy infectious disease, early pregnancy exposure to chemicals,paternal smoking and pregnancy complication;the protective factors are eating more high protein food during pregnancy,supplement of multivitamin during pregnancy and taking folic acid during pregnancy.