摘要
目的探讨目前与先天性心脏病发生相关的环境危险因素,为制定科学的预防措施及其病因学研究提供参考依据。方法采用以医院为基础的病例对照研究,对先心病组和对照组儿童的亲生父母亲进行统一的问卷调查。对所有研究因素经单因素分析和二项分类Logistic回归分析,筛选出与先心病发生相关的危险因素。结果研究分析了207名先天性心脏病患儿和414名对照的资料,按α=0.05水准,用χ2检验对42个研究因素进行单因素分析,初步筛选出14个可疑危险因素,再经二项分类Logistic逐步回归法,进行多因素分析,最终筛选出与先天性心脏病发生相关的7个危险因素,分别是母亲孕早期有不良精神因素(OR=5.767)、胎儿心律失常(OR=5.047)、孕早期饮酒(OR=4.869)、孕早期患呼吸道感染(OR=4.666)、孕早期接触有害物质(OR=3.731)、孕早期有噪音环境(OR=2.960)、母亲有不良生育史(OR=2.231)。结论怀孕早期是胎儿心脏发育的关键时期,母亲在孕早期有不良精神因素、饮酒、患呼吸道感染、接触有害物质、生活在噪音环境会增加胎儿发生先天性心脏病的风险。母亲既往有不良生育史及胎儿期发生心律失常,亦为先天性心脏病发生的危险因素。认识这些危险因素,加强孕早期保健防护、重视孕期产前检查对预防先天性心脏病发生具有重要现实意义。
Purpose To explore the possible environmental risk factors relevant to the occurrence of congenital heart disease（CHD）, and evaluate the relative importance of each risk factor, then provide scientific guidelines for CHD′s prevention. Methods Case-control study was designed, in which cases and controls′ parents were interviewed with the same questionnaire. Firstly, univariate conditional Logistic regression analysis was conducted to filter all the research factors. Then binary Logistic regression was used to filter suspicious risk factors. Results Enrolled 207 cases and 414 controls′ information were collected. Forteen suspicious risk factors entered the analysis of binary Logistic regression after univariate conditional regression analysis of 42 factors （alpha = 0. 05）. The analysis results showed that 7 factors were significantly associated with the occurrence of CHD. They were： maternal mental stress during early pregnancy（OR = 5. 767）, fetal arrhythmia（OR = 5. 047）, maternal drinking during early pregnancy（OR = 4. 869）, maternal respiratory infection during the first trimester of pregnancy（OR = 4. 666）, maternalcontact harmful substance during the first 12 weeks of pregnancy（OR = 3. 731 ）, noisy environment during early pregnancy（OR = 2. 960）, maternal ill bearing history（OR = 2. 231） ,according to the influence on the occurrence of CHD from strong to weak. Conclusions The early stage of pregnancy is the critical period for fetal cardiac development. Environmental factors play important roles in the occurrence of congenital heart defects. This study reveals that maternal mental stress, alcohol drinking, respiratory infection, contact of harmful substance, noisy environment during early pregnancy, fetal arrhythmia and maternal ill bearing history serve as independent risk factors of CHD. To avoid these risk factors during pregnancy, especially the first 12 weeks, is of great impor-tance to the prevention of CHD.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2007年第5期652-655,共4页
Fudan University Journal of Medical Sciences
基金
卫生部专项课题(2002BA709B08)
作者简介
通讯作者E-mail：yhgui@shmu．edu．cn
