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目的:系统评价中国围产儿先天性心脏病发生的主要危险因素,为其防治工作提供参考。方法:对国内26篇关于先天性心脏病发病危险因素的研究文献进行Meta分析。累计病例7 964例,对照12 929例。根据齐性检验结果计算各危险因素合并比值比(OR)及其95%可信区间(95%CI)模型。结果:先天性心脏病各危险因素的OR值及95%CI分别为:流产史1.69(1.24~2.31)、环境噪音1.28(0.39~4.19)、孕期检查胎儿异常2.31(1.25~4.27)、孕期服用药物1.88(1.57~2.23)、接触有害物质3.46(2.11~5.66)、近亲婚配史2.88(1.88~4.40)、被动吸烟1.16(0.69~1.95)、孕早期精神因素2.58(1.36~4.91)、父亲饮酒1.88(1.44~2.45)、孕早期感冒3.06(2.17~4.32)。结论:流产史、孕期检查胎儿异常、孕期服用药、早期精神因素、父亲饮酒、近亲婚配和孕早期感冒是先天性心脏病的危险因素。
Objective: To systematically evaluate the major risk factors of congenital heart disease in perinatal China and provide reference for its prevention and treatment. Methods: Meta-analysis was performed on 26 literatures about the risk factors of congenital heart disease in China. A total of 7 964 cases were included, compared with 12 929 cases. The odds ratio (OR) and its 95% confidence interval (95% CI) model for each risk factor were calculated based on the homogeneity test results. Results: The OR and 95% CI of risk factors of congenital heart disease were 1.69 (1.24 ~ 2.31), 1.28 (0.39 ~ 4.19), 1.31 (1.25 ~ 4.27) fetuses during pregnancy, Drug 1.88 (1.57 ~ 2.23), 3.46 (2.11 ~ 5.66) of contact with harmful substances, 2.88 (1.88 ~ 4.40) of inbreeding, 1.16 (0.69 ~ 1.95) of passive smoking, 2.58 (1.36 ~ 4.91) of early pregnancy, 1.88 (1.44 ~ 2.45), 3.06 (2.17 ~ 4.32) in early pregnancy. Conclusion: The history of abortion, fetus abnormalities during pregnancy, medication during pregnancy, early psychiatric factors, alcohol consumption by fathers, cousins and cousins are the risk factors of congenital heart disease.