目的 分析新生儿先天性心脏病(先心病)非遗传性危险因素,为预防先心病提供证据。方法 采用1∶2配对病例对照研究方法,选择2016年1月-2017年12月晋江市医院超声心动图检查明确为先心病的60例新生儿作为病例组,检查未发现先心病的健康新生儿120人作为对照组,进行回顾性问卷调查,行Logistic回归分析新生儿先心病的危险因素。结果 研究期间本院出生的新生儿5 564人,诊断先心病60例,发病率10.78‰。单因素分析显示,病例组的父亲饮酒、母亲孕早期感冒、不良生育史、主动及被动吸烟、移动电话使用累计时间、居室距马路距离,与对照组比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析:母亲孕早期感冒(OR=17.84,95%CI:2.58~123.41)、母亲主动及被动吸烟(OR=4.83,95%CI:1.82~12.79)、父亲饮酒(OR=6.20,95%CI:1.80~21.39)、居室距马路距离50~100 m(OR=9.11,95%CI:2.99~27.73)是先心病的独立危险因素。结论 新生儿先心病发病与多种环境危险因素暴露有关,认识这些危险因素,加强孕早期保健对预防先心病发生具有重要意义。

Objective To explore the possible non-inherited risk factors of congenital heart disease(CHD) in newborn infants in Jinjiang city,so as to provide evidence for the prevention of CHD. Methods A 1∶2 matched case-control study was designed,in which 60 CHD cases were diagnosed by echocardiography in Jinjiang Municipal Hospital from January 2016 to December 2017,and 120 healthy children were selected as control group.A questionnaire survey was carried out retrospectively among parents of CHD cases and controls.Logistic regression analysis was conducted to filter suspicious risk factors of CHD in newborn infants. Results Among the 5 564 newborn infants born in Jinjiang Municipal Hospital from January 2016 to December 2017,60 CHD cases were confirmed(10.78‰) by echocardiography.Univariate Logistic regression analysis showed that the following factors were all significantly associated with CHD in newborn infants(P<0.05), including paternal alcohol consumption,maternal cold in early pregnancy, adverse pregnancy outcomes,maternal active smoking and exposure to passive smoke,accumulated time for using mobile phone,dwelling place nearby major traffic road.Multivariate Logistic regression analysis showed that high risk factors for CHD included maternal cold in early pregnancy(OR=17.84,95%CI:2.58-123.41),maternal active smoking and exposure to passive smoke in early pregnancy(OR=4.83,95%CI:1.82-12.79),paternal alcohol consumption before pregnancy(OR=6.20,95%CI:1.80-21.39),dwelling place nearby traffic road 50-100 m(OR=9.11,95%CI:2.99-27.73). Conclusions The development of CHD in newborn infants might be related to the exposure of various environmental risk factors.It is of great importance to understand those risk factors and strengthen health care in early pregnancy to prevent CHD.