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目的充分利用廊坊市妇幼保健信息系统平台,提高对儿童先天性心脏病(congenital heart disease,CHD)的筛查质量,分析研究本地区儿童CHD发病率及影响因素,为当地政府决策提供可靠依据。方法采用望诊、听诊和彩色多普勒超声心动图相结合的方法对辖区内儿童进行监测。对确诊阳性患儿采用1∶2配对的病例对照研究方法、通过单因素分析和多因素条件logistic回归分析逐步筛选危险因素。结果廊坊市儿童CHD发病率为2.299%,其中孕早期感冒(OR=4.983)、妊娠合并症(OR=5.32)、孕早期情绪状况(OR=7.9)、孕早期接触农药(OR=7.812)、孕期被动吸烟(OR=5.23)是危险因素,孕前检查(OR=0.167)、孕期服用多种维生素(OR=0.033)是保护因素。结论母亲孕早期感冒、情绪差、接触农药、妊娠合并症、被动吸烟可增加新生儿患CHD的危险,而母亲孕前检查、及孕早期服用多种维生素则可以降低婴儿患CHD的危险。
Objective To make full use of the platform of maternal and child health information system in Langfang to improve the screening quality of children with congenital heart disease (CHD), analyze the incidence and influencing factors of CHD in children in this area, and provide a reliable basis for local government decision-making. Methods The method of combining diagnosis, auscultation and color Doppler echocardiography was used to monitor the children in the area. A case-control study of 1: 2 paired children with confirmed positives was performed to screen for risk factors by univariate analysis and multivariate logistic regression analysis. Results The incidence of CHD in children was 2.299% in the first trimester of pregnancy in Langfang City. The prevalence of CHD in early pregnancy was OR = 4.983, pregnancy complications (OR = 5.32), emotional status in early pregnancy (OR = 7.9) Passive smoking during pregnancy (OR = 5.23) was a risk factor. Pre-pregnancy tests (OR = 0.167) and multivitamins during pregnancy (OR = 0.033) were protective factors. CONCLUSIONS: In the first trimester of pregnancy, the mothers may have cold, poor mood, exposure to pesticides, pregnancy complications, and passive smoking may increase the risk of CHD. Neonatal CHD risk can be reduced by the mother’s pre-pregnancy examination and multivitamin in the first trimester.