广州市天河区出生缺陷相关因素的病例对照研究

目的：了解广州市天河区以医院为基础的围产儿出生缺陷发生水平及相关危险因素，为出生缺陷的干预提供科学依据。方法：以2011年10月1日至2012年9月30日在广州市天河区16家医院分娩或引产的孕28周至产后7 d的围产期出生缺陷患儿作为病例组，以1∶1配对方式选择同期在同一家医院分娩的正常新生儿作为对照组，对家长进行问卷调查，采用多因素Logistic回归分析筛选出生缺陷的危险因素。结果：出生缺陷发生率18.47‰，前3位出生缺陷依次为先天性心脏病、多指（趾）、唇裂。多因素Logistic回归分析显示，孕期放射线接触史（OR＝2.205，95％CI：1.178～3.481，P＝0.011）、孕期吸烟（OR＝1.899，95％CI：1.270～2.839，P＝0.002）、母亲先天性疾病史（ OR＝2.124，95％CI：1.243～3.629，P＝0.006）、孕出生缺陷儿史（OR＝3.893，95％CI：2.319～6.535，P＜0.001）是出生缺陷的危险因素；孕期经常摄入优质蛋白（OR＝0.874，95％CI：0.768～0.994，P＝0.040）是出生缺陷的保护因素。结论：减少和控制孕期主要危险因素是预防出生缺陷的重要环节。

Study of incidence and influencing factors of birth defect among perinatal infants in Tianhe District,Guangzhou

Objective：To explore the incidence and risk factors for birth defect among hospital-based perinatal infants and to provide scientific basis for intervention of birth defects .Methods：Perinatal infants in 16 hospitals in Tianhe District from October 2011 to September 2012 were selected as case group and normal newborn selected from same period and same hospital as control group , birth defect risk factors were analysed by multivariate Logistic regression .Results：Incidence of birth defects was 18.47‰, the former three birth defects were congenital heart disease, multi-finger（toe）, cleft lip.Logistic regression analysis showed that the history of radiation exposure during pregnancy （OR=2.205,95%CI：1.178-3.481,P=0.011）, smoking during pregnancy （OR=1.899, 95%CI：1.270 -2.839, P =0.002 ） , mother congenital history （ OR =2.124, 95%CI：1.243 -3.629, P =0.006）, history of pregnancy birth defects children （OR=3.893,95%CI：2.319-6.535,P〈0.001） were risk factors for birth defects;regular intake of quality protein during pregnancy （ OR=0.874,95%CI：0.768-0.994, P=0.040） was a protective factor for birth defects .Conclusion：Reduction and control of major risk factors during pregnancy is an important part of the prevention of birth defects .