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目的探讨母亲既往病史对出生缺陷的影响因素,为进一步指导优生优育和出生缺陷有效的干预提供科学依据。方法依据区域特点、经济水平、医疗条件等选择山西省代表性六个县(市)作为调查区域,对2006年—2008年的出生儿健康状况、母亲既往病史及家庭情况进行回顾性调查。用SAS 9.2进行随机效应Logistic回归分析。结果本次调查总人数36 716,出生缺陷儿494例,出生缺陷发生率为134.55/万。其中城镇197例,出生缺陷率为105.13/万;乡村297例,出生缺陷率为150.83/万。六县(市)中交口县出生缺陷发生率最高为208.39/万,怀仁市出生缺陷发生率最低为70.47/万。随机效应Logistic回归模型分析结果显示,同一地区近亲结婚、亲属有缺陷儿、妊娠妇女有贫血、甲状腺疾病史、既往缺陷儿史可使出生缺陷的危险性增加。结论妊娠妇女有既往病史会增加出生缺陷的风险。明确妊娠妇女既往病史,可对出生缺陷进行有效的干预。
Objective To explore the influencing factors of maternal past medical history on birth defects and provide scientific basis for further guiding the effective intervention of prenatal and postnatal care and birth defects. Methods Based on the regional characteristics, economic level and medical conditions, six representative counties (cities) in Shanxi Province were selected as the survey area. The health status of the children, the past medical history and the family condition of the patients from 2006 to 2008 were retrospectively investigated. Randomized Logistic Regression Analysis with SAS 9.2. Results The total number of the survey 36 716, 494 cases of birth defects, the incidence of birth defects was 134.55 / million. Among them, there are 197 towns and towns with a birth defect rate of 105.13 / million; 297 villages and a birth defect rate of 150.83 / 10,000. The highest incidence of birth defects in Zhongjiao County in the six counties (cities) was 208.39 / million, and the lowest incidence of birth defects in Huairen City was 70.47 / million. Random Logistic regression model analysis showed that the same area of marriage of kinsfolk, relatives with defective children, pregnant women with anemia, thyroid disease history, history of previous defects can increase the risk of birth defects. Conclusions Pregnant women with a prior history may increase the risk of birth defects. Clear past medical history of pregnant women, birth defects can be effectively intervened.