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目的探讨孕前及孕早期非遗传因素与胎儿先天性心脏病(CHD)的相关性。方法选取2013年1月-2014年10月间在该院行产前超声检查并确诊为CHD的胎儿728例为研究组;对照组选取与研究组相差2周以内的健康胎儿孕妇以1∶1比例进行匹配。调查两组胎儿母亲孕前及孕早期非遗传暴露因素,对可能诱发CHD的因素进行风险分析。结果孕早期感冒(OR=1.892,95%CI:1.204~3.143)负性生活事件(OR=2.272,95%CI:1.376~3.781)、生殖系统感染(OR=2.081,95%CI:1.269~3.507)、居住或工作地在化工厂附近(OR=1.936,95%CI:1.143~2.937)为胎儿先天性心脏病发生的独立危险因素。孕前及孕早期补充叶酸(OR=0.573,95%CI:0.376~0.916)、补充复合维生素(OR=0.541,95%CI:0.363~0.852)为胎儿先天性心脏病发生的保护因素。结论怀孕前及孕早期遭遇负性事件、孕早期感冒、生殖系统感染、居住地或单位附近有工厂会提升先天性心脏病发生风险;而孕前及孕早期补适量的复合维生素和叶酸可降低胎儿先天性心脏病发生的风险。
Objective To investigate the correlation between non-genetic factors and fetal congenital heart disease (CHD) before and during the first trimester of pregnancy. Methods A total of 728 fetuses diagnosed as CHD during the prenatal period in our hospital from January 2013 to October 2014 were selected as the study group and healthy fetuses within 1 week Ratio to match. To investigate the risk factors for CHD-induced CHD in both groups before and during pregnancy. Results The negative life events (OR = 2.272, 95% CI: 1.376 ~ 3.781), reproductive system infection (OR = 2.081, 95% CI: 1.269-3.507) ), And living or working near the chemical plant (OR = 1.936, 95% CI: 1.143-2.937) were independent risk factors for fetal congenital heart disease. Pretreatment and early pregnancy folic acid supplementation (OR = 0.573, 95% CI: 0.376 ~ 0.916), supplementation with multivitamins (OR = 0.541,95% CI: 0.363 ~ 0.852) is a protective factor for fetal congenital heart disease. CONCLUSIONS: Pre-pregnancy and early-pregnancy negative events, cold and reproductive system infections in the first trimester, and factories in or near the place of residence may increase the risk of congenital heart disease. However, pre-pregnancy and early-morning supplementation of multivitamins and folic acid can reduce the fetus Risk of congenital heart disease.