目的 探讨开封市围产儿出生缺陷的影响因素,为出生缺陷干预提供科学依据。 方法 2006年10月-2011年10月开封市468例出生缺陷儿的产妇为病例组,同一医院随机抽取 646 例于同时期分娩正常新生儿的产妇为对照组,进行回顾性调查,用单因素与多因素Logistic回归分析筛选出生缺陷的主要影响因素。 结果 研究因素中,有12个影响因素的发生率病例组与对照组的差异有统计学意义(P＜0.05),其中危险因素是7个,保护因素5个;对单因素分析中有统计学意义的变量进行多因素Logistic回归分析,其中,婚前体检(OR=0.65),经常食用鱼虾肉蛋类、牛奶豆类等优质蛋白类食物(OR=0.59)为出生缺陷的保护性因素;而母亲吸烟饮酒(OR=2.02)、母亲致畸因素接触史(OR=1.63)、孕育期用药(OR=4.23)、孕育期接触有害物质(OR=13.26)、居住地有污染源(OR=10.23)等5个因素为出生缺陷的危险因素。 结论 母亲吸烟饮酒、母亲致畸因素接触史、孕育期用药、孕育期接触有害物质、居住地有污染源等因素为出生缺陷的主要危险因素。减少和控制孕期主要危险因素是预防出生缺陷的重要环节。

Objective To explore the influencing factors of perinatal birth defect,and provide scientific basis for intervention. Methods 468 perinatal birth defects infants were selected as case group,and 646 normal infants as control group.According to the birth date and sex matching principle,Logistic regression was used to analysis muti-factor. Results Regular intake of fish,shrimp,meat,eggs,milk and beans during pregnancy(OR=0.59),participating in pre-marital medical examination(OR=0.65) were the protective factors of birth defects.The habit of smoking and drinking(OR=2.02),the history of mother exposure to teratogenic factors(OR=1.63),medication during pregnancy(OR=4.23),exposure to harmful substances during pregnancy(OR=13.26),environment pollution sources near residence(OR=10.23) were the risk factors of birth defects. Conclusion The habit of smoking and drinking,the history of mother exposure to teratogenic factors,medication during pregnancy,exposure to harmful substances during pregnancy,environment pollution sources near residence are the main risk factors of birth defects.Primary prevention to the causes is important to reduce birth defects.