广西地区母体孕期因素与新生儿先天性心脏病关联的病例对照研究

doi:10.11852/zgetbjzz2025-0191

摘要/Abstract

摘要： 目的了解广西地区新生儿先天性心脏病(CHD)的临床特征及与母体孕期因素的关联,为制定CHD的预防策略提供依据。方法采用1∶2配比的病例对照研究,选择2021年广西机构内出生并确诊为CHD的2 277例患儿作为病例组,匹配4 554例健康新生儿为对照组。收集和比较两组孕母的产检和分娩信息,采用单因素及多因素logistic回归分析CHD的危险因素。结果病例组中最常见CHD类型为动脉导管未闭(34.34%),其次是房间隔缺损(14.27%)、室间隔缺损(11.73%)。病例组儿童出生体重(t=23.383)和出生身长(t=27.121)均低于对照组(P<0.001)。多因素logistics回归分析显示,母亲分娩年龄≥35岁(OR=1.21, 95%CI: 1.10~1.34)、分娩孕周＜37周(OR=3.09, 95%CI: 2.43~3.92)、新生儿出生体重＜2 500g(OR=2.73, 95%CI: 2.12~3.51)、孕产妇BMI≥28kg/m²(OR=2.69, 95%CI: 1.92~3.34)、孕期未服用叶酸(OR=2.23, 95%CI:1.96~2.55)、有不良孕产史(OR=2.95, 95%CI: 2.47~3.52)、多胎(OR=6.85, 95%CI: 4.49~10.47)和孕期贫血(OR=3.63, 95%CI: 2.99~4.41)是新生儿发生CHD的危险因素(P<0.01)。结论广西地区新生儿CHD与多种母体孕期因素密切相关。应重点关注早产儿、低出生体重儿的心脏功能,并针对高龄、未服用叶酸、有不良孕产史、多胎、贫血的孕产妇做好孕期监测和干预,以降低CHD的发生风险。

关键词: 先天性心脏病, 孕期, 新生儿, 出生缺陷

Abstract: Objective To investigate the clinical characteristics of neonatal congenital heart disease (CHD) and its association with maternal factors during pregnancy in the Guangxi region, so as to provide evidence for developing CHD prevention strategies. Methods A 1∶2 matched case-control study was conducted. A total of 2 277 neonates diagnosed with CHD born in Guangxi maternity institutions in 2021 were selected as the case group, and 4 554 healthy neonates matched by gender and region served as the control group. Maternal antenatal and delivery information was collected for both groups. Univariate and multivariate logistic regression analysis were used to identify risk factors for CHD. Results The most common type of CHD in the case group was patent ductus arteriosus (34.34%), followed by atrial septal defect (14.27%) and ventricular septal defect (11.73%). Birth weight (t=23.383) and length (t=27.121) in the case group were significantly lower than those in the control group (P<0.001). Multivariate analysis revealed that maternal age at delivery ≥35 years (OR=1.21, 95%CI: 1.10 - 1.34), gestational age <37 weeks (OR=3.09, 95%CI: 2.43 - 3.92), neonatal birth weight <2 500g (OR=2.73, 95%CI: 2.12 - 3.51), pre-pregnancy BMI ≥ 28kg/m² (OR=2.69, 95%CI: 1.92 - 3.34), no folic acid supplementation during pregnancy (OR=2.23, 95%CI: 1.96 - 2.55), history of adverse pregnancy (OR=2.95, 95%CI: 2.47 - 3.52), multiple pregnancy (OR=6.85, 95%CI: 4.49 - 10.47), and anemia during pregnancy (OR=3.63, 95%CI: 2.99 - 4.41) were independent risk factors for neonatal CHD(P<0.01). Conclusions Neonatal CHD in the Guangxi region is closely associated with various maternal factors during pregnancy. Enhanced perinatal monitoring and intervention for pregnant women of advanced age, those with multiple pregnancies, anemia, no folic acid supplementation, or a history of adverse pregnancy are crucial to reduce the risk of CHD.

Key words: congenital heart disease, pregnancy, newborns, birth defect

中图分类号:

R179

韦霁珊, 韦萍, 黄旭华, 张宇星, 刘湘红, 莫靖媛, 玉群. 广西地区母体孕期因素与新生儿先天性心脏病关联的病例对照研究[J]. 中国儿童保健杂志, 2025, 33(12): 1392-1396.

WEI Jishan, WEI Ping, HUANG Xuhua, ZHANG Yuxing, LIU Xianghong, MO Jingyuan, YU Qun. Case-control study on the association between maternal factors during pregnancy and neonatal congenital heart disease in the Guangxi region[J]. Chinese Journal of Child Health Care, 2025, 33(12): 1392-1396.

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