青海省儿童先天性心脏病影响因素的调查研究

Investigation of factors influencing congenital heart disease among children in Qinghai Province

目的分析青海省儿童先天性心脏病(congenital heart disease,CHD)的影响因素。方法采用病例对照研究,按性别和年龄相差<1岁进行1∶2个体匹配,纳入315名<6岁的儿童(病例组105名,对照组210名),影响因素采用条件logistic回归分析模型分析。结果单因素条件logistic回归分析模型筛选出14个差异均有统计学意义的CHD影响因素(均P<0.001),包括居住地海拔、民族、出生体重、母亲文化程度、家庭收入、孕期接受宣教、首次妊娠、孕期补充维生素、孕期主要饮用水、孕期食用蔬菜水果、孕期食用油炸腌制品、孕期体育锻炼、孕期饲养动物、孕期定期体检;多因素条件logistic回归分析模型分析筛选出6个有统计学意义的CHD影响因素,包括海拔>2500 m(OR=4.84,95%CI:1.17~20.08,P=0.030)、出生体重≥2.5 kg(OR=0.10,95%CI:0.01~0.81,P=0.031)、母亲有大学及以上文化程度(OR=0.23,95%CI:0.07~0.76,P=0.016)、家庭人均月收入>1500元(OR=0.03,95%CI:0.01~0.21,P=0.001)、孕期补充维生素(OR=0.06,95%CI:0.01~0.40,P=0.004)、孕期饮用纯净水(OR=0.05,95%CI:0.01~0.35,P=0.003)。结论与低海拔地区相比,居住在高海拔地区发生CHD的危险会高出4.84倍。家庭收入、母亲文化程度、母亲孕期生活方式与CHD的发生可能有关。

Objective This study aimed to analyze the factors influencing congenital heart disease(CHD)in children within Qinghai Province.Methods A 1∶2 sex-and age-matched(age difference less than 1 year)case-control study was employed,incorporating 315 children under 6 years(105 in the case group,210 in the control group).Conditional logistic regression models were utilized to analyze influencing factors.Results Univariate conditional logistic regression model identified 14 significant factors(P<0.001)influencing congenital heart disease,including altitude of residence,ethnicity,birth weight,maternal education,family income,receiving missionary education during pregnancy,first pregnancy,vitamin supplementation during pregnancy,main drinking water during pregnancy,consumption of vegetables and fruits during pregnancy,consumption of fried foods during pregnancy,have physical exercise during pregnancy,keeping animals during pregnancy,and regular medical checkups during pregnancy.Multivariate conditional logistic regression identified six significant factors,including altitude>2500 m(OR=4.84,95%CI:1.17-20.08,P=0.030),birth weight≥2.5 kg(OR=0.10,95%CI:0.01-0.81,P=0.031),maternal education level of university or above(OR=0.23,95%CI:0.07-0.76,P=0.016),monthly per capita household income>1500 yuan(OR=0.03,95%CI:0.01-0.21,P=0.001),vitamin supplementation during pregnancy(OR=0.06,95%CI:0.01-0.40,P=0.004),and consumption of purified water during pregnancy(OR=0.05,95%CI:0.01-0.35,P=0.003).Conclusions The risk of CHD was found to be 4.84 times higher in high-altitude residences compared to low-altitude ones.Furthermore,family income,maternal education,and maternal lifestyle during pregnancy may be linked with the occurrence of CHD.