育龄妇女孕早期患病与新生儿先天性心脏病的关联

目的 探讨育龄妇女孕早期患病与新生儿先天性心脏病之间的关联。方法 采用分层多阶段随机抽样方法，以问卷调查方式收集2010－2013年陕西省怀孕且结局明确的育龄妇女及其子女的相关信息。应用倾向值匹配法，对孕早期患病组和未患病组育龄妇女进行1 ∶ 1匹配。以是否生育先天性心脏病患儿为因变量，以母亲孕早期是否患病为自变量，通过逐步校正混杂因素建立logistic回归模型。结果 共纳入28 680对母亲及新生儿，孕早期患病者5 807人（20.25%）。匹配后孕早期患病组和未患病组分别为5 436人。在控制混杂因素后，母亲孕早期患病可增加新生儿先天性心脏病的发病风险（OR=1.86，95% CI：1.23～2.81），孕早期患感冒（OR=2.19，95% CI：1.46～3.28）、妇科疾病（OR=4.74，95% CI：2.03～11.09）和糖尿病（OR=14.00，95% CI：1.64～119.21）是生育先天性心脏病患儿的危险因素。结论 育龄妇女孕早期患感冒、妇科疾病和糖尿病与子代发生先天性心脏病有关。

Association between congenital heart disease and maternal disease in early pregnancy in women of childbearing age

Objective To investigate the relationship between maternal disease in early pregnancy of women of childbearing age and congenital heart disease of neonates. Methods A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women during 2010-2013 in Shaanxi province. Propensity score (PS) matched (1:1) analysis was used to match participants with diseases to those without disease in early pregnancy. Through the control of the confounders step by step, a logistic regression model was established to evaluate the ORs of congenital heart disease according to the independent variable of maternal disease. Results A total of 28 680 pairs of mothers and infants were included in this study, the proportion of the women with disease in early pregnancy was 20.25% (5 807). After PS matching, 5 436 pairs were matched. After adjusting all confounding factors, the multivariable logistic regression analysis results showed that maternal disease (OR=1.86, 95%CI:1.23-2.81), especially cold (OR=2.19, 95%CI:1.46-3.28), gynecological disease (OR=4.74, 95%CI:2.03-11.09) and diabetes (OR=14.00, 95%CI:1.64-119.21), in early pregnancy were the risk factors for congenital heart disease of neonate. Conclusion In women of childbearing age, disease in early pregnancy, especially cold, gynecological disease and diabetes, can increase the risk of congenital heart disease in neonates.