生理相关因素对出生缺陷影响的病例对照研究

目的：探讨出生缺陷的生理相关危险因素。方法收集2009年4月至2013年12月在西安交通大学第一附属医院诊断为出生缺陷的患儿147例，以医院为基础的1：2匹配病例对照研究，对产妇的一般情况、既往生育史、孕期异常状况及患病情况等资料，使用单因素分析和多因素条件Logistic回归进行比较分析。结果经单因素分析显示，高龄产妇、怀孕次数多、自然流产次数多、早孕反应严重、孕前和孕期有疾病史均为出生缺陷可能的危险因素；多因素条件Logistic回归分析表明，早孕反应严重（OR＝2．197，95％CI：1．634～2．954）、孕前有疾病史（OR＝2．089，95％CI：1．037～4．206）、孕期有疾病史（OR＝1．562，95％CI：1．021～2．390）是出生缺陷的危险因素。结论重视孕前－围孕期保健，加强围孕期健康教育，重视严重早孕反应的预防和全面治疗，鼓励新婚夫妇进行婚前和孕前体检，有针对性的对不同身体状况的产妇进行孕期保健指导，从而降低出生缺陷的发生率，提高出生人口素质。

Case-control study on physiological related factors on birth defects

Objective To explore the physiological related factors of birth defects .Methods A hospital based 1:2 matched case-control study was conducted among 147 cases of birth defects diagnosed in the First Affiliated Hospital of Xi ’ an Jiaotong University during the period of April 2009 to December 2013.Univariate and multivariate Logistic regression analyses were carried out to analyze the general condition, history of fertility, abnormal symptoms and disease during pregnancy .Results Univariate analysis results showed that advanced maternal age, frequent pregnancy, frequent spontaneous abortion, severe morning sickness, sickness history before and during pregnancy were the risk factors of birth defects .Multivariate Logistic regression analysis showed that severe morning sickness ( OR=2.197,95%CI:1.634-2.954), sickness before pregnancy (OR=2.089,95%CI:1.037-4.206) and during pregnancy (OR=1.562,95%CI:1.021-2.390 ) were the risk factors of birth defects .Conclusion Prenatal and perinatal health education should be strengthened .Great importance should be attached to prevent severe morning sickness and to carry out education and thorough treatment .The couples before marriage and pregnancy should be advocated to have physical examinations .Pregnancy care instruction should be provided aiming at different physical conditions of pregnant women , so as to effectively reduce the occurrence of birth defects and improve the birth quality .