中国出生缺陷危险因素的Meta分析

[目的]探讨影响中国出生缺陷发生的主要危险因素，为预防决策提供依据。[方法]利用Meta分析的随机效应模型综合分析国内1991-2004年关于出生缺陷发病危险因素的研究文献14篇。累计病例3054例，对照4281例。[结果]单因素分析合并比值比（OR）分别为：母文化程度（0．7301），流产史（3．3768），孕早期服药（2．9642）、接触化学毒物（3．2927）、剧烈呕吐（10．6965）、感染（6．7954）、接触农药（5．9415）、TORCH感染（2．0370）、负性精神刺激（2．1331），父吸烟（2．2480）和饮酒（2．6646）；多因素分析合并。比值比（OR）分别为：母文化程度（0．6545），孕期营养（3．4488），孕早期服药（3．4892）和负性精神刺激（1．6294）。[结论]影响中国出生缺陷发生的主要危险因素为母文化程度，孕期营养，孕早期服药、感染、剧烈呕吐、接触化学毒物，父吸烟和父饮酒等。

META-ANALYSIS OF THE MAJOR RISK FACTORS ON BIRTH DEFECTS IN CHINA

[Objective]To provide evidences for decision-making on birth defects prevention through exploring the major risk factors related to the incidence of birth defects in China.[Methods]The results from 14 epidemiological studies on risk factors of birth defects from 1991 to 2004 were analyzed synthetically by Meta-analysis. Fixed-effects model and random-effects model were applied to process these data. The cumulative cases and controls were 3054 and 4281,respectively.[Results]The pooled odds ratio(OR)values of single-factor-analysis were as follows:maternal degree of education(0.7301),history of abortion(3.3768),drugs abuse(2.9642)?exposure to chemical toxicant(3.2927)?vomitting violently(10.6965)?infections(6.7954)?exposure to pesticide(5.9415)?infections of TORCH(2.0370)?negative spiritual stimulus(2.1331)during early pregnancy,paternal smoking(2.2480)and drinking(2.6646). The pooled odds ratio(OR)values of multiple-factor-analysis were as follows:maternal degree of education(0.6545),nutrition during pregnancy(3.4488),drugs abuse(3.4892)and negative spiritual stimulus(1.6294)during early pregnancy.[Conclusion]The major factors influencing the incidence of birth defects in China were maternal degree of education,nutrition during pregnancy,drugs abuse?infections?vomitting violently and exposure to chemical toxicant during early pregnancy,paternal smoking and drinking and so on.