目的 分析新疆北疆部分地区新生儿先天性心脏病(CHD)患病情况及其相关影响因素,为当地CHD的防治提供理论依据。方法 选取2021年1月1日—12月31日在阿勒泰地区人民医院和伊犁州妇幼保健院出生,并在新生儿期诊断为CHD的145例患儿为病例组,通过新疆妇幼健康云平台监测系统收集患儿母亲的产前检查资料以及分娩记录情况,按照孕妇孕时年龄作为匹配依据变量,根据1∶2匹配选择与病例组同期的正常新生儿290名为对照组,采用病例对照研究进行单因素分析和多因素分析,探讨新疆地区先天性心脏病的影响因素。结果 本研究纳入病例动脉导管未闭占比最高,共106例,占比73.10%。单因素分析结果显示病例组和对照组母亲的孕前BMI、孕次、产次、是否贫血、Rh血型、糖尿病史、新生儿性别、胎龄、出生体重、分娩方式差异均有统计学意义(P<0.05)。多因素分析结果显示孕产妇的孕前BMI为超重或肥胖(OR=1.919,95%CI:1.174~3.427)、孕次≥2次(2次:OR=4.449,95%CI:2.380~8.318;≥3次:OR=15.716,95%CI:5.680~43.487)、贫血(OR=6.073,95%CI:2.193~16.813)、Rh阴性血型(OR=2.748,95%CI:1.210~11.788)、糖尿病史(OR=2.463,95%CI:1.693~8.760)、新生儿性别为女性(OR=1.753,95%CI:1.141~2.694)、低出生体重儿(OR=3.685,95%CI:1.086~12.497)或巨大儿(OR=10.062,95%CI:2.667~37.959)、剖宫产分娩(OR=2.491,95%CI:1.515~4.097)为CHD的危险因素(P<0.05);足月儿(OR=0.484,95%CI:0.272~0.861)为CHD的保护因素(P<0.05)。 结论 CHD的发生与孕产妇孕前BMI、孕次、糖尿病史、贫血、出生体重、胎龄、分娩方式等有关。应大力提倡孕前检查,提供遗传咨询服务,以降低CHD的发病率。
Abstract
Objective To analyze the prevalence and associated factors of congenital heart disease (CHD) among newborns in some areas of northern Xinjiang, China, in order to provide theoretical foundations for prevention and control strategies in the region. Methods From January 1st to December 31st, 2021, 145 neonates diagnosed with CHD at Altay Regional People's Hospital and Ili Prefecture Maternal and Child Health Hospital were selected as the case group. Maternal prenatal examination data and delivery records were collected through the Xinjiang Maternal and Child Health Cloud Monitoring System. Based on maternal age during pregnancy, 290 healthy neonates born during the same period were matched at a ratio of 1∶2 as the control group. Univariate and multivariate analysis were conducted using a case-control study design to explore the influencing factors of CHD in the Xinjiang region. Results Among the cases, patent ductus arteriosus was the most prevalent (73.10%, 106 cases). Univariate analysis showed statistically significant differences in pre-pregnancy BMI, gravidity, parity, presence of anemia, Rh blood type, history of diabetes, newborn gender, gestational age, birth weight, and mode of delivery between the case and control groups (P<0.05). Multivariate analysis revealed that pre-pregnancy overweight or obese (OR=1.919, 95%CI: 1.174 - 3.427), gravidity ≥ 2 times (2 times:OR=4.449, 95%CI:2.380 - 8.318,≥3 times:OR=15.716,95%CI:5.680~43.487), anemia (OR=6.073, 95%CI: 2.193 - 16.813), Rh-negative blood type (OR=2.748, 95%CI: 1.210 - 11.788), history of diabetes (OR=2.463, 95%CI: 1.693 - 8.760), female newborn gender (OR=1.753, 95%CI: 1.141 - 2.694), low birth weight (OR=3.685, 95%CI: 1.086 - 12.497), macrosomia (OR=10.062, 95%CI: 2.667 - 37.959), and cesarean delivery (OR=2.491, 95%CI: 1.515 - 4.097) were risk factors for CHD (P<0.05). Full-term neonates served as a protective factor (OR=0.484, 95%CI: 0.272 - 0.861) against CHD (P<0.05). Conclusions CHD is associated with pre-pregnancy BMI, gravidity, history of diabetes, anemia, birth weight, gestational age, and mode of delivery. Pre-pregnancy testing and genetic counseling services should be strongly promoted to reduce the incidence of CHD.
关键词
先天性心脏病 /
新生儿 /
遗传
Key words
congenital heart disease /
neonates /
hereditary
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