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目的探讨母亲饮食因素在神经管畸形(NTD)发病中的作用。方法选择山西省出生缺陷高发的平定、昔阳、太谷和泽州4个县,进行以人群为基础的出生缺陷病例对照研究。病例为2003年1月至2005年6月在4个县监测到的363例NTD病例,对照为同期在同地区出生的523名无体表畸形的健康婴儿。结果单因素分析结果表明,与NTD发生有关的饮食因素有食用肉类、蛋奶、豆类、腌菜、发芽土豆、食物烹调习惯、饮用水水源类型、饮啤酒、红酒或米酒和饮茶。在调整妇女文化程度和畸形生育史的基础上,多因素。logistic回归分析表明,肉类和豆类为NTD的保护因素, NTD的危险性随着肉类、豆类食用频率的增加逐渐下降,其在人群中的归因危险度(PAR)分别为69．4％和22．0％。食用腌菜为危险因素,NTD危险性随着腌菜食用频率增加而显著增加,具有明显的剂量反应关系,其PAR值为18．5％。此外,饮用河水或池塘水的妇女较饮用井水或自来水者的危险性增高(OR=3．42,95％CI:1．44-8．09),每天饮茶者较不饮或偶尔饮茶妇女的危险性增高(OR=4．65,95％CI:1．41-15．36),但二者PAR值较低,分别为4．7％和2．6％。结论富含叶酸的肉类和豆类对NTD发生具有显著的保护作用。怀孕前后食用腌菜、饮用河水或池塘水以及每天饮茶是NTD的危险因素。
Objective To explore the role of maternal diet in the pathogenesis of neural tube defects (NTD). Methods A case-control study of population-based birth defects was conducted in four counties of Pingding, Xiyang, Taigu and Zezhou with high incidence of birth defects in Shanxi Province. The cases were 363 cases of NTD detected in 4 counties from January 2003 to June 2005. The controls were 523 healthy babies without body surface deformity who were born in the same area in the same period. Results The results of univariate analysis showed that dietary factors such as meat, custard, beans, pickles, sprouting potatoes, food cooking habits, drinking water sources, drinking beer, red wine or rice wine and drinking tea were all related to the occurrence of NTD. On the basis of adjusting the education level of women and the history of abnormal birth, many factors. Logistic regression analysis showed that meat and beans were the protective factors of NTD. The risk of NTD gradually decreased with the increasing frequency of eating meat and beans, and its attributable risk (PAR) in the population was 69%. 4% and 22.0%. The consumption of pickled vegetables was a risk factor. The risk of NTD increased significantly with the increase of eating frequency of pickles, with a significant dose-response relationship with a PAR value of 18.5%. In addition, women who drink river water or pond water have a higher risk of drinking well water or tap water (OR = 3.42, 95% CI: 1.44-8.09), drink less or drink occasionally Tea women were at increased risk (OR = 4.65, 95% CI: 1.41-15.36), but their PAR values were lower at 4.7% and 2.6% respectively. Conclusion Folic acid-rich meat and beans have a significant protective effect on NTD. Eating pickles before and after pregnancy, drinking river water or pond water, and drinking tea daily is a risk factor for NTD.