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目的了解孕早期环境因素对儿童先天性心脏病(简称先心病)的影响,为防治先心病的发生提供科学依据。方法选择2005年1—6月在中南大学湘雅一医院和湘雅二医院治疗的无先心病家族史的0～7岁湖南籍的汉族先心病患儿为病例,采用以医院为基础的1∶1配对病例-对照研究方法,对先心病病例和对照的母亲进行问卷调查,对资料进行单因素分析和多因素条件Logistic回归分析。结果多因素分析结果显示,摄入叶酸(OR=0.340,95%CI:0.178～0.649)、饮牛奶(OR=0.660,95%CI:0.460～0.947)、食用肉类(OR=0.771,95%CI:0.583～0.867)、妊娠反应(OR=0.457,95%CI:0.271～0.770)可预防先心病的发生;感染(OR=2.736,95%CI:1.462～5.121)、用药(OR=2.735,95%CI:1.483～5.044)、化学毒物接触(OR=2.764,95%CI:1.065～7.177)、重大精神刺激(OR=2.211,95%CI:1.022～4.782)是引起先心病发生的危险因素。结论孕妇加强孕早期营养,保持良好的心态,避免感染、用药,防止化学毒物的接触,可预防儿童先心病的发生。
Objective To understand the influence of environmental factors on congenital heart disease (CHD) in early pregnancy, and provide a scientific basis for the prevention and treatment of CHD. Methods From January to June 2005, children with CHD who were from Hunan Province aged 0 ~ 7 years without familial family history of CHD treated at Xiangya Hospital and Xiangya Second Hospital of Central South University from January to June in 2005 were selected as cases and hospital-based 1 : 1 Matched case-control study, the mothers of congenital heart disease cases and controls were surveyed, and the data were analyzed by univariate analysis and multivariate conditional logistic regression analysis. Results Multivariate analysis showed that the intake of fats (OR = 0.340, 95% CI: 0.178-0.649), milk for drinking (OR = 0.660, 95% CI: 0.460-0.947) (OR = 2.736, 95% CI: 1.462-5.121), medication (OR = 2.735, CI: 0.583-0.867) and pregnancy (OR = 0.457,95% CI: 0.271-0.770) (OR = 2.211, 95% CI: 1.022 ~ 4.782) were the risk factors for the development of CHD (95% CI: 1.483-5.044) . Conclusion Pregnant women to strengthen early pregnancy nutrition, maintain a good attitude, to avoid infection, medication, to prevent the contact of chemical toxins, children with CHD can be prevented.