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[目的]探究孕前6个月至孕早期3个月内(围孕期)父母的生活环境及职业有害因素暴露与单纯型先天性小耳畸形发病的相关性。[方法]采用病例对照研究设计,对2015年6月—2016年6月期间于上海交通大学医学院附属第九人民医院就诊的0~10岁单纯型先天性小耳畸形患者(病例组)及同年龄段因外伤、发热或急诊就诊患儿(对照组)的父母进行面对面访谈和问卷调查,收集其社会人口学以及围孕期生活环境、生活习惯、职业接触等资料,将获得的数据进行单因素卡方检验和非条件多因素logistic回归分析。[结果]最终获得124例病例和126例对照的问卷资料。单因素分析发现:围孕期居住地附近(≤3 km2)有排放污水、固体废物和空气污染物的工业生产企业,围孕期居住地室内装修或添置新家具,母亲围孕期职业环境中的重金属暴露、染发烫发、被动吸烟以及父亲围孕期重金属和有机溶剂的职业有害因素暴露皆可能是先天性小耳畸形的危险因素(均P<0.05)。非条件多因素logistic回归分析的结果显示:母亲文化程度低(OR=0.737,95%CI:0.545~0.996),围孕期室内装修(OR=4.546,95%CI:1.668~12.390),围孕期母亲被动吸烟频率高(OR=1.420,95%CI:1.059~1.903)以及父亲职业环境中重金属暴露(OR=2.880,95%CI:1.036~8.007)均可能是小耳畸形发病的相关危险因素。[结论]围孕期多种环境和职业有害因素暴露对小耳畸形发病的影响值得关注和进一步研究。
[Objective] To explore the correlation between the living environment of parents and the exposure of occupational harmful factors and the incidence of simple congenital malformations in the first 6 months of pregnancy to the first trimester of pregnancy. [Methods] A case-control study design was conducted. The patients with simple congenital malformation of amblyopia (case group) aged 0-10 years and attending the 9th People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine between June 2015 and June 2016 Age-matched parents and children with traumatic, fever or emergency treatment (control group) conducted face-to-face interviews and questionnaires to collect data on their socio-demographic and perinatal living environment, living habits and occupational exposure, Chi-square test and unconditional multivariate logistic regression analysis. [Results] The questionnaire data of 124 cases and 126 controls were finally obtained. Univariate analysis found that industrial enterprises that discharge sewage, solid waste and air pollutants within the peri-residential area (≤3 km2), interior decoration during the pregnancy period, or new furniture purchase, and heavy metal exposure in mothers’ occupational occupational environment during pregnancy , Hair perm, passive smoking and occupational exposure to heavy metals and organic solvents during pregnancy were all risk factors for congenital malformation (all P <0.05). The result of unconditional multivariate logistic regression analysis showed that the educational level of mothers was lower (OR = 0.737, 95% CI: 0.545-0.996), inter-trimester intercourse (OR = 4.546,95% CI: 1.668-12.390) The frequency of passive smoking (OR = 1.420, 95% CI: 1.059-1.903) and heavy metal exposure (OR = 2.880, 95% CI: 1.036-8.007) in the father’s occupational environment were all risk factors for the development of microtia. [Conclusion] The effects of various environmental and occupational harmful factors exposure during the pregnancy on the development of small ear malformation deserve attention and further study.