先天性心脏病非遗传性危险因素病例对照研究

Case-control study on non-inherited risk factors of congenital heart disease in infants

目的分析先天性心脏病(先心病,CHD)非遗传性危险因素,为预防先心病提供证据。方法选择2017年8月至2019年8月于西北妇女儿童医院出生,经心脏超声诊断为先心病的555例婴儿为病例组;选择同期、同性别、在同所医院出生,经心脏超声检查未发现先心病的555例健康婴儿为对照组。采用1∶1配对病例对照研究方法进行回顾性问卷调查,并进行Logistic回归分析新生儿先心病的危险因素。结果研究期间出生新生儿共52791人,诊断为先心病555例,发病率为10.51‰。单因素分析显示,病例组母亲有自然流产史(χ^2=16.567)、孕早期感冒(χ^2=24.654)、孕早期被动吸烟(χ^2=14.995)、使用微波炉(χ^2=12.164)、工作强度(χ^2=36.846)分布与对照组比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,母亲孕早期感冒(OR=1.511,95%CI:1.183~1.930)、孕早期被动吸烟(OR=1.780,95%CI:1.338~2.369)均为先心病的独立危险因素(均P<0.05)。结论先心病发病与多种环境危险因素暴露有关,认识这些危险因素对预防先心病的发生具有重要意义。

Objective To explore possible non-inherited risk factors of congenital heart disease(CHD)in infants,so as to provide evidence for prevention of CHD.Methods 555 infants who were born in our hospital from August 23,2017 to August 23,2019 and were diagnosed as CHD by echocardiography were selected as the case group.Another 555 healthy infants who were born in our hospital at the same time and same gender were selected as the control group.A 1∶1 matched case-control study method was used to conduct a retrospective quastionnaire investigatoin and logistic regression was used to analyze the risk factors of neonatal CHD.Results During the study period,52791 infants were born in our Hospital,and 555 cases of CHD were confirmed(10.51‰)by echocardiography.Univariate logistic regression analysis showed that the following factors were all significantly associated with CHD in infants(all P<0.05):history of spontaneous abortion(χ^2=16.567),maternal cold in early pregnancy(χ^2=24.654),passive smoking in early pregnancy(χ^2=14.995),use of microwave oven(χ^2=12.164),and high work stress intensity(χ^2=36.846).Multivariate logistic regression analysis showed that maternal cold in early pregnancy(OR=1.511,95%CI:1.183~1.930)and passive smoking in early pregnancy(OR=1.780,95%CI:1.338~2.369)were both high risk factors for CHD.Conclusions The development of CHD in infants might be related to exposure of various environmental risk factors.It is of great importance to recognize those risk factors and strengthen healthcare in early pregnancy for prevention of CHD.