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目的探讨胎儿先天性心脏病(FCHD)的高危因素,为FCHD的早期预防提供参考依据。方法采用病例对照分析方法,对2012年1月-2013年12月来该院行超声检查的孕妇进行问卷式调查,统计FCHD的危险因素。经超声诊断并经随访证实为心脏主要结构畸形的胎儿为病例组,共149例,按照1∶1的比例选择对照组,即超声诊断为正常胎儿的孕妇149例。采用单因素和多因素条件Logistic回归分析,统计FCHD危险因素。结果多因素Logistic回归分析筛选出5个变量,分别是孕前或孕早期服药史(OR=2.793,95%CI:1.336~5.844)、孕早期感冒(OR=3.932,95%CI:1.862~8.304)、电脑和手机等辐射物质的使用频率(OR=3.147,95%CI:1.942~5.009)、接触有毒有害化学物质(OR=2.491,95%CI:1.133~5.477)、孕早期适当服用叶酸(OR=0.321,95%CI:0.152~0.676)。结论孕前或孕早期服药史、孕早期感冒、电脑和手机等辐射物质的使用频率、接触有毒有害化学物质是FCHD的主要危险因素,孕早期适当服用叶酸是FCHD的保护因素。这些危险因素的干预对预防FCHD的发生有现实意义。
Objective To investigate the risk factors of fetal congenital heart disease (FCHD) and provide a reference for the early prevention of FCHD. Methods A case-control study was conducted to investigate the risk factors of FCHD in pregnant women who underwent ultrasonography from January 2012 to December 2013 in a questionnaire survey. A total of 149 cases of fetuses diagnosed as major structural malformations by sonography were followed up. A total of 149 pregnant women with ultrasound diagnosed as normal fetuses were selected according to the ratio of 1: 1. Univariate and multivariate logistic regression analysis was used to analyze the risk factors of FCHD. Results Five factors were screened by multivariate Logistic regression analysis, including the medication history before or during the first trimester (OR = 2.793, 95% CI: 1.336-5.844), early pregnancy flu (OR = 3.932, 95% CI: 1.862-8.304) (OR = 3.147, 95% CI: 1.942-5.009), exposure to toxic and harmful chemicals (OR = 2.491, 95% CI: 1.133-5.477) = 0.321, 95% CI: 0.152-0.676). Conclusions The frequency of exposure to cold, the radiation of computers and mobile phones during the first trimester of pregnancy or the first trimester of pregnancy is the main risk factor of FCHD exposure to toxic and harmful chemicals. Appropriate folic acid intake in early pregnancy is the protective factor of FCHD. The intervention of these risk factors is of practical significance in preventing the occurrence of FCHD.