新生儿先天性心脏病危险因素的病例对照研究

目的探讨新生儿先天性心脏病（简称＂先心病＂）的类型及其可能的危险因素,为制定预防措施提供参考依据。方法采用1∶1配对病例对照研究方法,选取2011年5月至2013年12月在本院新生儿科住院治疗的先心病患儿为病例组,无先心病的患儿为对照组,对两组患儿的亲生父母进行统一问卷调查。对所有研究因素进行单因素及多因素条件Logistic回归分析.筛选出与先心病发生相关的危险因素。结果研究期间本院新生儿科共收治3682例患儿,病例组和对照组各纳入139例。139例先心病患儿以室间隔缺损为主（34.5%）,其次为房间隔缺损＋室间隔缺损（14.4%）、房间隔缺损（10.8%）和室间隔缺损＋动脉导管未闭（10.1%）。母亲孕前及孕早期糖尿病（OR=7.321）、孕早期服用抗生素（OR=6.996）、孕早期被动吸烟（OR=4.948）、先心病家族史（OR=3.252）和孕早期上呼吸道感染（OR=3.461）均是先心病发生的相关危险因素（P〈0.05）。结论应加强孕期健康教育,提高产前产后诊断水平,以早期防治先心病,从而有效降低先心病的发病率。

Risk factors of neonatal congenital heart disease: a case-control study

Objective To investigate different types of neonatal congenital heart diseases（CHD） and their correlating risk factors in order to provide clinical evidence for the prevention and treatment of CHD. Methods Patients were enrolled from hospitalized neonates in Gansu Provincial maternity and child-care hospital from the May. 2011 to Dec. 2013. A case-control study was performed by enrolling 139 newborns with CHD and 139 neonates without CHD. Questionnaires were completed by birth parents of all infants. Single variate and multivariate logistic regression studies were used to identify risk factors that had led to CHD. Results Among the 3682 infants admitted during the study period,139 infants were diagnosed with CHD. The most common deformities were ventricular septal defect（VSD： 34. 5%）,followed by atrial septal defect complicated with ventricular septal defect（ASD ＋VSD： 14. 4%）,atrial septal defect（ ASD： 10. 8%）,and atrial septal defect with patent ductus arteriosus（ ASD ＋ PDA： 10. 1%）. Pre-pregnancy and early-pregnancy diabetes（ OR = 7. 321）,antibiotic usage during early pregnancy（OR = 6. 996）,passive smoking during early pregnancy（ OR =4. 948）,Upper respiratory tract infection during early pregnancy（ OR = 3. 461） andfamily history of CHD（OR = 3. 252） were risk factors of CHD development（ P〈0. 05）. Conclusions In order to decrease the occurrence of CHD,prenatal health education,early diagnosis and management of CHD during prenatal and postnatal period are important in early management of CHD and to improve the awareness and to decreased the incidence of CHD.