2011年上海市新生儿先天性心脏病影响因素的病例对照研究

[目的]分析2011年上海市新生儿先天性心脏病（CHD）发生情况，探讨CHD相关的危险因素，为人群预防措施的制定提供科学依据。[方法]采用病例对照研究方法，结合病史摘录和调查问卷，采集2011年上海市464例CHD患儿和1585例非CHD对照儿童父母的孕期及孕前期生活行为和环境暴露因素等信息。对危险因素的探索采用logistic回归进行单因素和多因素分析。[结果]2011年上海市新生儿CHD以房间隔缺损为主（29．98％），其次为动脉导管未闭（28．05％）和室间隔缺损（11．03％）o经多元logistic回归分析（X^2=116．53，P〈0．0001）发现，多胞胎妊娠、受孕时父亲年龄≥50岁、母亲未进行正规产检、母亲孕期经历负性生活事件和母亲孕期烟草暴露是CHD可能的危险因素，其OR值分别为22．65、4．60、1．31、2．52和1．62。[结论]选择最佳生育年龄，避免不良行为习惯，保持孕期心理健康，加强孕期保健，进行正规产前检查，有利于降低CHD发生的风险。

A Case-Control Study on Influencing Factors of Congenital Heart Disease in Neonates in Shanghai, 2011

[ Objective ] To analyze the occurrence of congenital heart disease （CHD） among neonates in Shanghai in 2011, to explore the risk factors associated with CHD, and to provide scientific basis for preventive measures. [ Methods ] A case-control study of CHD was conducted, combining with medical history and questionnaire, to collect information on life style and environmental factors of their parents of 464 CHD cases and 1585 healthy neonates in Shanghai in 2011. Risk factors were determined using single-factor and multivariate logistic regression analyses. [ Results ] In 2011, most CHD in Shanghai were found to be atrial septal defect （29.98%）, followed by patent ductus arteriosus I28.05%） and ventricular septal defect （11.03%）. Multivariate logistic regression （X^2~=116,53, P 〈 0.000 1） showed that multiple pregnancy, father＇s age above 50 years, mothers without regular prenatal care, mothers＇ experiences negative life events during pregnancy, and tobacco exposure during pregnancy were the possible risk factors （OR=22.65, 4.60, 1.31, 2.52, and 1.62, respectively）. [ Conclusion ] Choosing the best child-bearing age, avoiding bad habits, maintaining mental health, strengthening health care, and taking regular prenatal care during preanancv would held reduce the risk of CHD in neonates.