广西高发出生缺陷发生的影响因素分析

Influencing factors of high-incidence birth defects in Guangxi

目的探讨广西高发出生缺陷发生的影响因素,为制定出生缺陷的干预措施提供依据。方法采用成组病例对照的研究方法,对广西7个市3 175例出生缺陷围产儿(包括先天性心脏病、唇腭裂、先天性脑积水、神经管缺陷、尿道下裂等)和3 179例正常围产儿的父母进行问卷调查,并对可能影响高发出生缺陷发生的相关因素进行单因素及多因素logistic回归分析。结果多因素logistic回归分析结果显示:父亲年龄及吸烟程度、叶酸指数与高发出生缺陷相关(P<0.05)。高发出生缺陷发生的危险因素包括孕早期未接受过优生检测、母亲孕早期患病、母亲怀孕前患病、母亲孕早期用药、母亲怀孕前后接触过猫狗等宠物、母亲有特殊食品嗜好(P均<0.05)。结论母亲孕早期未接受优生检测、孕前/早期患病、孕早期用药、怀孕前后有宠物接触史以及母亲有特殊食品嗜好是广西地区高发出生缺陷发生的危险因素,在广西可从孕前与孕期保健、生活环境因素等多方面进行出生缺陷干预。

Objective To explore the influencing factors of high-incidence birth defects in Guangxi so as to provide the basis for formulating the intervention measures of birth defects.Methods A group case-control study was conducted, in which a questionnaire survey was carried out among parents of 3 175 perinatal infant with birth defects（including congenital heart disease,cleft lip and cleft palate,congenital hydrocephalus,neural tube defects and hypospadias） and 3 179 normal perinatal infants from 7 cities in Guangxi. Univariate and multivariate logistic regression analysis were used to analyze the related influencing factors of high-incidence birth defects. Results Multivariate logistic regression analysis revealed that age,severity of smoking and folacin index of fathers correlated with high-incidence birth defects（P〈0.05）.The risk factors for the occurrence of high-incidence birth defects included no eugenics detection in early pregnancy stage,mother′s suffering from an illness in early pregnancy stage or before pregnancy,mother′s taking medication in early pregnancy stage, mother′s contacting with pets（such as cats and dogs） before and after pregnancy and mother′s hobby of special food（all P〈0.05）. Conclusion Mother′s no receiving eugenics detection in early pregnancy stage,suffering from an illness in early pregnancy stage or before pregnancy,taking medication in early pregnancy,contacting with pets before and after pregnancy and hobby of special food are the risk factors for the occurrence of high-incidence birth defects in Guangxi.Prenatal and pregnant healthcare as well as living environmental factors can be involved in the birth defects intervention in Guangxi.