母亲孕早期患病对出生缺陷的随机效应Logistic模型分析

Analysis of the impact of the diseases during the pregnancy on birth defects with random effects Logistic model

目的通过调查山西省部分县(市)出生缺陷的现状,重点分析孕早期患病情况对出生缺陷的影响,为制定针对性的预防措施提供依据。方法以山西省6县(市)2006-2008年3年期间所有的出生儿母亲或其一级亲属为调查对象,采用随机效应Logistic模型分析不同地区间的异质性,进一步探讨妊娠妇女孕早期患有感冒、发热、先兆流产、生殖道感染、妊娠呕吐等对出生缺陷的影响。结果随机效应Logistic模型分析结果提示,不同地区间存在组间异质性即组内相关性,考虑了不同地区的差异,出生缺陷的发生与孕早期患发热、感冒、先兆流产密切相关,妊娠早期罹患发热(OR=1.855)、感冒(OR=1.924)、先兆流产(OR=3.361)是出生缺陷的危险因素。结论出生缺陷的发生与孕期患病情况密切相关,应提高妊娠妇女患病情况的重视程度,并尽早采取有效的预防和干预措施,提高生育质量。

Objective To analyze the impact of the diseases during the early pregnancy of mother on the prevalence of birth defects,so as to provide evidence for making preventive measures through surveying birth defects in counties（ cities） of Shanxi Province.Methods All the new mother and first degree relatives in six counties of Shanxi Province,during 2006 to 2008,were recruited.The random effects Logistic model was used to analyze the heterogeneity between six counties（ cities）,then the impact of the risk of early pregnancy disease on birth defects was explored,such as fever,colds,threatened abortion,genital tract infection and vomiting of pregnancy.Results The results of random effects Logistic model suggested that different regions had heterogeneity between groups,considering the difference,suffering from fever during early pregnancy,colds,threatened abortion were closely related to birth defects; the mother suffering from fever during early pregnancy（ OR = 1.855）,colds（ OR = 1.924）,threatened abortion（ OR = 3.361） increased the risk of birth defects.Conclusions The incidence of birth defects is closely related to the prevalence during pregnancy.We should increase the degree of attention to the pregnant women,and take effective prevention and early intervention measures to improve reproductive quality.