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目的 探讨新生儿先天性心脏病(先心病)患病率和妊娠初期增补叶酸的预防效果。方法 对1992年1月1日至1998年12月31日嘉兴市妇幼保健院出生的全部活婴31 470例，进行先心病前瞻性调查；调查1996年8月1日至1998年7月31日7 445例活产婴儿的母亲孕前1月至孕后3月内增补叶酸情况与先心病的发病关系；调查1994年6月1日至1998年12月31日出生的217例先心病的母亲妊娠初期增补叶酸情况。结果 31 470例新生儿中检得先心病312例，不包括单纯性动脉导管未闭和缺损直径小于5 mm的房间隔缺损(ASD)。其中彩色多普勒超声心动图(CDFM)诊断298例，尸检确诊14例，患病率9.91‰。室间隔缺损(VSD)居首位(51.6%)，患病率5.12‰。重症复杂先心病新生儿期死亡32例，病死率10.3%。7 445例新生儿的母亲孕期增补叶酸情况与先心病患病率关系，增补叶酸组先心病患病率7.43‰，未补组患病率15.17‰。两组患病率差异有显著性意义，(P<0.01)，相对危险度(RR)0.4898，归因危险度(AR)0.00774，归因危险比数(ARP)51.02%。重症复杂先心病患病率未补组为增补组的4.6倍。217例先心病中母亲孕初增补叶酸组占30.9%，未补组占69.1%。重症复杂畸形增补组7例占11.4%，未补组34例占22.7%。结论 应用CDFM是先心病检出率增加的主要原因。妊娠初期增补叶?
Objective To investigate the prevalence of congenital heart disease (CHD) in neonates and the preventive effect of folic acid supplementation during the first trimester of pregnancy. Methods A total of 31 470 all living babies born in Jiaxing Maternal and Child Health Hospital from January 1, 1992 to December 31, 1998 were prospectively investigated for congenital heart disease. The investigation was conducted from August 1, 1996 to July 31, 1998 The incidence of congenital heart disease in 7,445 mothers of live-born infants during the first trimester to the third trimester of pregnancy was investigated; and 217 mothers with congenital heart disease who were born between June 1, 1994 and December 31, 1998 were surveyed at the beginning of pregnancy Fill folic acid situation. Results Among 31 470 newborns, 312 cases were diagnosed with congenital heart disease, not including patent ductus arteriosus and atrial septal defect (ASD) less than 5 mm in diameter. Among them, 298 cases were diagnosed by color Doppler echocardiography (CDFM) and 14 cases were confirmed by autopsy, the prevalence was 9.91%. Ventricular septal defect (VSD) ranked first (51.6%), the prevalence was 5.12 ‰. Severe complex congenital heart disease neonatal 32 deaths, the fatality rate of 10.3%. 7 445 cases of mothers of newborns during pregnancy folic acid supplementation and congenital heart disease prevalence, supplementation folic acid group prevalence of congenital heart disease 7.43 ‰, 15.17 ‰ not supplemented group prevalence. There was significant difference between the two groups (P <0.01). The relative risk (RR) 0.4898, attributable risk (AR) 0.00774 and attributable risk ratio (ARP) 51.02%. Prevalence of severe and complicated congenital heart disease group did not make up 4.6 times the supplement group. 217 cases of congenital heart disease mothers early pregnancy folic acid supplementation group accounted for 30.9%, 69.1% did not make up group. Severe complex deformity additional group of 7 cases accounted for 11.4%, 34 cases of non-supplement group accounted for 22.7%. Conclusion Application of CDFM is the main reason for the increased detection rate of congenital heart disease. Early pregnancy supplement leaves?