尿道下裂危险因素的病例对照研究

目的 探讨尿道下裂病因。方法 采用以医院为基础的1:2配比的病例对照研究方法,以统一的调查表及调查方式对107倒尿道下裂及214例对照进行面对面问卷调查,应用SAS 6.12软件对所有调查因素进行单因素及多因素logistic回归分析。结果 胎儿尿道下裂的发生与母亲孕前自然流产史(OR=3.87,95％CI:1.60～9.39)、孕期发生先兆流产(OR=3.57,95％CI:1.31～9.64)、孕早期感冒伴发热(OR=7.63,95％CI:2.50～23.24)、孕中期用抗感染和/或解热止痛药(OR=16.46,95％CI;3.46～78.21)、父亲职业性接触农药(OR=3.70,95％CI:1.49～9.16)及胎儿低出生体重(OR=12.62,95％CI:2.97～53.67)呈正相关,与母亲孕早期增加蛋白质类营养(OR=0.33,95％CI:O.15～0.74)呈负相关。结论 母亲孕前自然流产史、孕期发生先兆流产、孕早期感冒伴发热、孕中期用抗感染和/或解热止痛药、父亲职业性接触农药、胎儿低出生体重等可能增加胎儿发生尿道下裂的危险,而母亲孕早期增加蛋白质类营养可能降低胎儿发生尿道下裂的危险。

A case-control study on risk factors of hypospadias

Objectivc Hypospadias is one of the most commonly seen urogenital congenital malformations in males and to identify its etiological factors. Methods A hospital-based case-control study was conducted, with 107 hypospadias cases. Two matched controls per case were randomly selected. Both cases and controls were face to face interviewed with a uniformed questionnaire. Conditional logistic regression model was used for univariable and multivariate analysis on SAS 6. 12 to estimate odds ratios (OR) and 95 per cent confidence internals (95 % CI). Results Data from multiple conditional logistic regression analysis showed that hypospadias was positively associated with maternal history of spontaneous abortion (OR = 3. 87, 95% CI: 1. 60--9. 39), with threatened abortion in the first or second trimester (OR =3. 57, 95% CI: 1. 31--9. 64), with common cold accompanied fever in the first trimester (OR = 7. 63,95% CI: 2. 50--23. 24), with maternal drug (antibiotic, analgesiscs) exposure during the second trimester (OR = 16. 46, 95% CI: 3. 46--78. 21), with paternal exposure to pesticides occupationally (OR = 3. 70, 95 % CI: 1. 49--9. 16), with neonatal low birth weight (OR = 12. 62, 95 % CI: 2. 97--53. 67), but was negatively associated with maternal diet supplemented with protein in the first trimester (OR = 0. 33, 95% CI: 0. 15--0. 74). Conclusions The risk factors of hypospadias seemed to include maternal history of spontaneous abortion, threatened abortion in the first or second trimester, maternal common cold accompanied fever in the first trimester, maternal drug exposure during the second trimester, paternal occupational exposure to pesticides, neonatal low birth weight. However, maternal diet supplemented with protein probably acted as the protective factor for neonatal hypospadias in the first trimester.