妊娠妇女既往病史对出生缺陷影响因素的分析

Analysis of the infl uencing factors on birth defects of the past medical history of pregnant women

目的探讨母亲既往病史对出生缺陷的影响因素,为进一步指导优生优育和出生缺陷有效的干预提供科学依据。方法依据区域特点、经济水平、医疗条件等选择山西省代表性六个县(市)作为调查区域,对2006年—2008年的出生儿健康状况、母亲既往病史及家庭情况进行回顾性调查。用SAS 9.2进行随机效应Logistic回归分析。结果本次调查总人数36 716,出生缺陷儿494例,出生缺陷发生率为134.55/万。其中城镇197例,出生缺陷率为105.13/万;乡村297例,出生缺陷率为150.83/万。六县(市)中交口县出生缺陷发生率最高为208.39/万,怀仁市出生缺陷发生率最低为70.47/万。随机效应Logistic回归模型分析结果显示,同一地区近亲结婚、亲属有缺陷儿、妊娠妇女有贫血、甲状腺疾病史、既往缺陷儿史可使出生缺陷的危险性增加。结论妊娠妇女有既往病史会增加出生缺陷的风险。明确妊娠妇女既往病史,可对出生缺陷进行有效的干预。

Objective：To probe into the factors of the past medical history of pregnant women attributing to the birth defects and provide the scientific evidence for guidance of rearing better children and future research on intervention of birth defects. Method：According to the level of economic and social development,medical condition,six counties of Shanxi Province were chosen to be the survey region. The health condition of children who were born between 2006 and 2008,the past medical history of the mothers and their family conditions were investigated retrospectively. All the data had been input into Epidata. Random effects Logistic regression analysis was done by SAS 9.2 software. Result：The total number of 36 716 people was included in the survey. Among them,494 cases showed birth defects. The incidence rate of birth defects is 134.55 / 10000.A total of 197 cases of birth defects were found in urban areas. The incidence rate of birth defects is 105.13 / 10000. A total of 297 cases of birth defects were found in rural areas. The incidence rate of birth defects is 150.83 / 10000. The highest incidence of birth defects was 208.39 / 10000 in Jiaokou of the six counties. The lowest incidence of birth defects was 70.47 /10000 in Huairen. Random effects logistic regression model analysis showed that,consanguineous marriage in the same area,relatives giving birth to defective children,a history of anemia,thyroid disease and previously giving birth to defective children of the pregnant women can increase the risk of birth defects. Conclusion：Pregnant women with a past medical history will increase the risk of birth defects. Clear pregnant women past medical history,may carry on the effective intervention of birth defects.