胎儿先天畸形的发生及其危险因素研究

Occurrence and risk factors of congenital malformations of fetus

目的探讨胎儿先天畸形的发生现状及其危险因素。方法选取2015年9月至2018年9月间年在我院产科建卡就诊且发现胎儿先天畸形的120例孕产妇临床资料作为观察组,另选取同期120例正常孕妇作为对照组,采用Logistic回归方程进行计算,分析胎儿先天畸形的发生现状及其危险因素。结果在120例胎儿CM中,单系统畸形发生率明显高于多系统畸形,各系统分布比例占比前三分别为中枢神经系统(40%)、头面部(20%)与心血管系统(15%)。对比有无胎儿CM孕产妇的一般资料,发现两组在年龄、孕期合并症、产次、孕期感染、发热、用药、从事高危工作(接触化学毒物的行业)、半年内新装修房子或经常驾驶新车、异常生育史、吸烟、酗酒、前期有畸形怀孕史或家族史等一般资料上出现较大差异,数据对比具有统计学意义(P<0.05),将上述有差异资料带入Logistic回归方程计算,证实其均是导致胎儿CM的相关危险因素。结论导致胎儿先天畸形的诱发因素很多,建议临床应加强产前筛查,强调按时产检的重要性,做好产前宣教,杜绝一切有可能诱发胎儿先天畸形的危险因素。

Objective:To investigate the occurrence and risk factors of fetal congenital malformations. Methods:From September 2015 to September 2018,120 pregnant and lying-in women with congenital fetal malformation were selected as the observation group and 120 normal pregnant women as the control group.The incidence and risk factors of congenital fetal malformation were analyzed by logistic regression equation. Results:In 120 cases of fetal CM,the incidence of single system malformations was significantly higher than that of multiple system malformations.The distribution of each system was 40% in the central nervous system,20% in the head and face,and 15% in the cardiovascular system.Compared the general data of pregnant and lying-in women with or without fetal CM,it was found that the two groups had age,complications during pregnancy,parity,infection during pregnancy,fever,medication,high-risk work(exposured to chemical poisons),new house decoration within six months or frequent driving new cars,abnormal birth history,smoking,alcohol abuse,abnormal pregnancy history in the early stage,and there were significant differences in family history and other general data(P<0.05).These differences were brought into the Logistic regression equation to confirm that they were related risk factors for fetal CM. Conclusion:There are many predisposing factors of fetal congenital malformation.It is suggested that prenatal screening should be strengthened,the importance of timely prenatal examination should be emphasized,prenatal propaganda should be done well,and all possible risk factors of fetal congenital malformation should be eliminated.