盐城地区围产儿出生缺陷相关影响因素分析

目的通过对围产儿出生缺陷情况结果的监测，探究其相关影响因素，并为干预措施提供理论依据。方法截取我院2008年3月-2012年1月共100例具有出生缺陷的围产儿，回顾性调查先天异常发生的情况，并以他们为病例组，采用病例对照研究，按照1：3的原则选出同时期出生，监测正常的新生儿为对照组，结果用单因素及多因素Logistic回归分析方法筛选出相关影响因素。结果4年共监测围产儿21258例，发现出现出生缺陷100例，出生缺陷发生率4．7‰。缺陷种类前5位分别为总唇腭裂、多指（趾）、先天性心脏病、先天性脑积水、肢体短缩，构成比分别为11．7％，6．5％，4．38％，4．15%/0，3．65％。单因素分析显示，吸烟或饮酒、胎产次、感冒发热（服用感冒药）等为危险因素。保护因素为婚检、孕检、服用叶酸、孕期经常食用肉蛋奶类或蔬菜水果类。多因素分析显示吸烟或饮酒、妊娠合并症、暴露于化学物质或X线等危险物质为危险因素，婚检、孕检为出生缺陷的保护因素。结论出生缺陷干预可从多方面进行，加强出生缺陷监测，提倡婚检、孕检，减少围孕期有害物质的接触，减少吸烟饮酒等不良生活习惯，加强孕期营养等。

Analysis of related influence factor on perinatal birth defects.

Objective： To explore the related influence factor which may generate birth defects by monitoring the Perinatal birth defects results. Methods： A total of 100 Pefinatal Infants who showed birth defect symptoms in our hospital from March 2008 to January 2012, were monitored by a retrospective investigation and selected as case group. A case-control study was conducted, the infants in case group matched to the perinatal in group according to the ratio of 1： 3. The results of related influencing factors were measured by the univariate factor and multiple factors Logistic regression analysis. Results： There were 21 258 Perinatal Infants monitored in 4 years, including 100 infants with birth defect. The incidence of BD is 4.7‰. The top five birth defects were total cleft lip and cleft, polydactyly, congenital heart disease, congenital hydrocephalus, limb shortening and the constituent ratio respectively are 11.7%, 6.5%, 4.38%, 4.15% and 3.65%.Univariate regression analysis showed that smoking or drinking, fetal parity, cold or fever were the risk factors.The protect factors were premarital check-up, pregestational examination, administration of folic acid and pregnancy of abundant diet. Multivariate regression analysis showed that premarital check-up, pregestational examination were the protective factors of birth defects; smoking or drinking, pregnancy complication, exposure to chemical substances or X-ray were the risk factors of birth defect. Conclusion： The intervention of birth defects to reduce the incidence of birth defects contains strengthening birth defects monitoring, advocating the check-up and pregnancy test, reducing the opportunity of exposure to the harmful substances, reducing the bad habits such as smoking or drinking, improving nutrition during pregnancy etc.