尿道下裂发病相关危险因素的研究

目的　研究可能引起尿道下裂发病率增高的危险因素。　方法　采用病例 对照研究 ,调查 30个可能的暴露危险因素 ,病例组 2 10例 ,同期对照组 4 2 0例。对患儿和正常儿童的母亲采用问卷式调查 ,数据进行单因素非条件Logistic分析和多因素非条件Logistic逐步回归分析。　结果　本组病例均为汉族 ,有家族史者 5例 (2 .4 % ) ;危险因素 :怀孕年龄 (OR :38.6 3)、先兆流产 (OR :4 .71)、黄体酮 (OR :3.6 4 )、雌激素 (OR :5 .4 1)、杀虫剂 (OR :2 .39)、有机溶剂 (OR :2 .12 )、怀孕季节 (OR :1.86 )和洗洁精 (OR :1.87) ,而OR值 <1的有 :流产次数 (OR :0 .81)、足月儿 (OR :0 .2 7)、正常胎儿体重 (OR :0 .0 0 5 ) ,其余 17项调查因素无阳性意义。　结论　先兆流产、胎儿未足月、低体重儿和外界环境中一些影响内分泌干扰剂 (杀虫剂、洗洁精、有机溶剂、黄体酮、雌激素 )可能是尿道下裂发生的危险因素 ,可能促进了近年来尿道下裂发病率的增加。

Study of risk factors associated with hypospadias

Objective To study the risk factors which lead to increase in the incidence rate of hypospadias. Methods A case-control design was used.The mothers of 210 cases and 420 controls were interviewed by telephone or face-to-face,and the questionnaires were answered.Thirty probable risk factors were investigated.Statistical analysis was performed using univariate and multivariate unconditional Logistic regression analyses for evaluation of the data. Results All boys with hypospadias in the case group were of Han nationality.Only 5 cases had positive family history.Odds ratio (OR) of the factors investigated were:pregnant age (OR,38.63),threatened abortion (OR,4.71),progestin (OR,3.64),estrogen (OR,5.1),pesticide (OR,2.39),organic solvents (OR,2.12),season of pregnancy (OR,1.86) and detergent (OR, 1.87).But OR of frequency of abortion,weeks of gestation and birth weight were less than 1.The results of other 17 investigated factors were negative. Conclusions Threatened abortion,nonfull-term fetus,low birth weight and some environmental endocrine-disturbing chemicals ( pesticide,detergent,organic solvents,progestin and estrogen) may be risk factors associated with hypospadias.These environmental endocrine-disturbing chemicals may increase the incidence rate of hypospadias.