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目的分析南阳地区120例新生儿先天性心脏病(CHD)筛查结果,探讨发病的相关危险因素。方法随机抽取南阳地区法定机构出生的20 637例新生儿进行CHD筛查,CHD患儿120例为CHD组,健康患儿450例作为非CHD组。通过调查问卷的形式,单因素Logistic分析和多因素Logistic回归模型对CHD危险因素进行统计分析。结果 20 637例新生儿筛查,CHD患儿占120例,发病率为0.58%,均只含1种CHD。房间隔缺损、室间隔缺损及动脉导管未闭是发病最多的3种CHD。单因素Logistic分析,母亲年龄、父亲年龄、孕周、产检次数、TORCH感染、负性生活事件、产妇营养不良、烟草暴露与CHD具有相关性,P<0.05。多因素Logistic分析显示,多胞胎、父亲年龄≥50岁,产检次数<9次,负性生活事件及烟草暴露是CHD发病的危险因素,经Logistic回归模型似然比检验,P值均<0.05。结论对育龄期人群应做好优生优育的健康教育,严格戒烟和拒绝被动吸烟。指导孕妇理性调节自身情绪,维持孕产期的心理平衡。要叮嘱孕妇和家属定期来院进行产检,尽早诊断先天性缺陷以终止妊娠。对新生儿应广泛普查,及早发现CHD并进行治疗,降低新生儿死亡率。
Objective To analyze the screening results of 120 newborns with congenital heart disease (NIDD) in Nanyang area and explore the related risk factors. Methods Totally 20 637 newborns born in statutory institutions in Nanyang District were enrolled in this study. 120 children with CHD were enrolled as CHD group, and 450 healthy children were enrolled as non-CHD group. The risk factors of CHD were statistically analyzed by means of questionnaire, univariate Logistic analysis and multivariate Logistic regression model. Results A total of 20 637 neonates were screened, and 120 children with CHD had a prevalence of 0.58%, all of whom had only one type of CHD. Atrial septal defect, ventricular septal defect and patent ductus arteriosus is the most common disease of the three kinds of CHD. Univariate Logistic analysis, maternal age, father’s age, gestational age, number of births, TORCH infection, negative life events, maternal malnutrition, tobacco exposure were associated with CHD, P <0.05. Multivariate Logistic analysis showed that multiple births, father’s age was over 50 years old, the number of births was less than 9 times, negative life events and tobacco exposure were risk factors of CHD. P value was <0.05 by Logistic regression model test . Conclusions Health education for prenatal and postnatal care should be done for people of childbearing age, smoking should be stopped strictly and passive smoking should be refused. Guide pregnant women rational regulation of their own emotions, to maintain the psychological balance of pregnancy. To urge pregnant women and their families to come regularly to hospital for childbirth, early diagnosis of congenital defects to terminate the pregnancy. The newborn should be widely census, early detection of CHD and treatment, reduce neonatal mortality.