珠海地区先天性心脏病流行状况及危险因素研究

Prevalence and risk factors of congenital heart disease in Zhuhai

目的了解珠海地区先天性心脏病(CHD)的流行状况,筛查与CHD相关的主要危险因素,为制订相应的干预措施提供依据。方法将2013年和2014年珠海市妇幼保健院和珠海市斗门区妇幼保健院出生的所有活产新生儿作为调查对象,调查CHD的流行状况。以确诊的CHD患儿为病例组,采用1∶1配对病例对照研究方法,通过调查问卷的方式,调查其父母工作生活环境、生活行为习惯等因素。采用Logistic回归分析统计方法,筛查出珠海地区与CHD发病相关的高危因素。结果珠海地区2013年CHD发病率为0.83%。2014年CHD发病率为0.86%。最常见的心脏病类型为室间隔缺损,占56.03%。通过Logistic回归分析筛查出珠海地区CHD相关的高危因素,包括孕妇高龄(OR=3.74,P=0.000)、孕妇吸烟或被动吸烟(OR=1.52,P=0.009)、孕早期不良精神刺激(OR=2.08,P=0.000)、孕早期患呼吸道疾病(OR=13.06,P=0.014)、孕期化学毒物接触(OR=5.34,P=0.031)。结论珠海地区CHD发病率高,其中以简单型CHD为主。母亲应适龄怀孕、避免吸烟,孕期避免不良精神刺激及化学毒物的接触,预防感冒,以减少CHD的发生。

Objective To learn the prevalence of congenital heart disease （CHD） in Zhuhai and screen the major risk factors associated with CHD, so as to lay a foundation for the development of appropriate interventions. Methods The survey was conducted in all living newborns born in Zhuhai Maternal and Child Health Hospital and Doumen Maternal and Child Health Hospital of Zhuhai City in 2013 and 2014 to investigate the prevalence of CHD. A 1：1 matched case-control study was carried out, in which children diagnosed with CHD was the case group. Through a questionnaire survey, factors such as their parents＂ working and living environment, living habits and so on were explored. The Logistic regression analysis was used to screen out the high risk factors associated with the incidence of CHD in Zhuhai City. Results The incidence of CHD in Zhuhai was 0.83% in 2013 and 0.86% in 2014. The most common type of CHD was ventricular septal defect, accountted for 56.03%. High risk factors associated with CHD in Zhuhai included advanced maternal age （OR=3.74, P=O.000）, smoking or passive smoking when pregnant （OR=1.52, P=0.009）, adverse mental stimulation in early pregnancy （0R=2.08, P=0.000）, suffering from respiratory diseases in early pregnancy （OR= 13.06, P=0.014）, and exposure to chemical poisons during pregnancy （0R=5.34, P=0.031）. Condusion CHD incidence is high in Zhuhai, mainly based on simple-type CHD, Mothers should get pregnant at the right age, avoid smoking and exposure to adverse mental stimulation and chemical poisons during pregnancy, prevent colds, maybe reduce the incidence of CHD.