西安市三区2010至2014年围产儿出生缺陷影响因素分析

Influencing factors of birth defects among perinatal infants in three districts of Xi'an City during 2010-2014

目的探讨西安市围产儿出生缺陷影响因素,为制定有针对性的预防工作提供科学依据。方法 2015年6至10月,由西安市妇幼保健院组织本次病例对照研究。病例资料来源于2010至2014年西安市三区出生缺陷监测登记系统上报的活产出生缺陷儿。采用1:1病例对照研究,统一设计调查表,由经过培训的各医院专业人员填写,采用Logistics回归方法进行出生缺陷影响因素分析。结果出生缺陷儿共1 237例,出生缺陷前六位依次为多指(趾)(271例)、总唇腭裂(205例)、神经管畸形(83例)、先天性心脏病(72例)、外耳其他畸形(66例)及先天性脑积水(50例)。出生缺陷发病的危险因素包括孕早期患病、未婚检、围孕期接触有毒有害物质、未进行产前筛查以及孕期合并症及并发症(OR分别为1.98、1.41、3.05、7.65、3.39,均P<0.05);出生缺陷发病的保护因素为家庭收入高、产妇文化程度高、无异常生育史(OR分别为0.57、0.43、0.22,均P<0.05)。结论应重视出生缺陷的一级预防,降低本地区出生缺陷水平,提高人口素质。

Objective To explore the influencing factors of birth defects in Xi＇an and provide basis for prevention and control work.Methods The 1：1 case-control study was conducted by Xi＇an Maternal and Child Health Hospital from June to October in 2015. Data was from the cases of birth defects reported in Birth Defects Monitoring and Registering System in three districts in Xi＇an from 2010 to 2014.Designed survey forms were filled by professional staff in different hospitals. Logistic regression models were used to explore the influencing factors of birth defects. Results There were 1 237 cases of birth defects. The first six main birth defects were polydactyly（ n = 271）,total cleft lip（ n = 205）,neural tube defects（ n = 83）,congenital heart disease（ n = 72）,other external ear malformations（ n = 66） and neural tube defects（ n = 50）. The risk factors for birth defects were illness during the first trimester of pregnancy,no premarital examination,periconceptional exposure to harmful substances,no prenatal screening and complications of pregnancy（ OR value was 1. 98,1. 41,3. 05,7. 65 and 3. 39,respectively,all P〈 0. 05）. The protective factors were higher family income,higher education level of pregnant women and no abnormal reproductive history（ OR value was 0. 57,0. 43 and 0. 22,respectively,all P〈 0. 05）. Conclusion It is necessary to pay attention to primary prevention of birth defects in order to reduce the incidence of birth defects and increase the quality of population.