围产儿出生缺陷及相关危险因素分析

Analysis of the Monitoring Results of Perinatal Birth Defects and Related Risk Factors

【目的】探讨围产儿出生缺陷的发生情况并分析与其相关的危险因素。【方法】选取2011年3月至2015年3月于本院出生且发生出生缺陷的围产儿110例作为观察组，根据l：3的原则选择同时间段出生的正常的新生儿作为对照组，对发生出生缺陷的临床资料进行回顾性分析，将可能与出生缺陷相关的因素进行单因素及Logistic多因素分析。【结果】观察组高文化程度者所占比例、人均收入水平高者所占比例及家庭居住在城市者所占比例显著低于对照组，差异有统计学意义（P〈0.05）；单N素分析显示，吸烟或者饮酒、感冒发热、妊娠合并症、服用其他药物、胎产次、孕期体力劳动、暴力与化学物质或者X线、不良孕产史、孕妇孕期有精神病史为出生缺陷的危险因素，而孕检、婚检、营养状况良好及服用叶酸为其保护因素（P〈0.05）；多因素Logistic分析显示，孕检、婚检为出生缺陷的保护因素，妊娠期合并症、暴露于化学物质或X线及吸烟或饮酒为出生缺陷的独立危险因素。【结论】围产儿出生缺陷的影响因素较多，可通过提倡孕检、婚检、在围孕期减少化学物质等有害物质的接触、降低孕期合并症的发生等来预防出生缺陷的发生。

[Objective]To investigate the occurrence of birth defects in perinatal infants and to analyze the related risk factors. [Methods]From March 2011 to March 2015, 110 cases of perinatal birth defect that occurred in our hos- pital were selected as the observation group. According to 1：3 matching principle, 330 cases of normal newborn at the same time were regarded as the controls. Clinical data of birth defects were retrospectively analyzed, and the possible factors associated with birth defects were evaluated by Logistic univariate and multivariate analysis. [Results]Compared with the control group, the proportion of high education, high per capita income level , and urban residence were lower in the observation group; the difference was statistically significant （P〈0.05）. Univariate analysis showed that smoking or alcohol drinking, fever, complications of pregnancy, medication, parity （counts of pregnancy and delivery）, physical labor during pregnancy, violence and chemical or X-ray exposure, adverse pregnancy history, and history of mental illness are risk factors for birth defects, while pregnancy and premarital examinations, good nu- tritional condition, and the use of folic acid are protective factors. Multivariate analysis also showed that the use of pregnancy and premarital tests were protective factors for birth defects, while pregnancy complications, exposure tO chemicals or x-ray, and smoking or drinking alcohol were independent risk factors of birth defects and were statistically significant （ P -0.05）. [Conclusion]Birth defect is attributed to many factors. By means of advocating call for premarital examination, pregnancy check-up, reducing exposure to chemicals and other harmful substances in the periconceptional period and the occurrence of pregnancy complications , the occurrence of birth defects can be reduced.