【摘要】 目的先天畸形严重影响出生人口素质,分析城市地区与先天畸形发生有关的影响因素及各因素的作用强度(危险度、预防分值),为该病切实可行的群体干预对策和措施提供科学依据。方法采用11配比病例对照研究方法,在山东省部分城市中按照WHO诊断标准获取围生期确诊的先天畸形病例169例,包括解剖和结构畸形,不包括单纯代谢和功能异常。对照按同性别、同地区、同出生日期(±2月)在正常围产儿中选择。对所有研究对象的父母(调查对象)进行统一的问卷调查和血清学检测。资料进行单因素和多因素条件Lo-gistic回归分析,计算指标为影响因素的作用强度和预防分值。结果先天畸形影响因素为孕妇知道孕时间长、孕早期发热、孕早期服用解热镇痛药、孕早期接触化学毒物、父亲接触有害物、负性事件刺激,OR值分别为5.490,3.352,3.501,3.147,4.495,1.113;AR%分别为81.78%,70.16%,71.43%,68.22%,77.75%,10.15%;PAR%分别为13.91%,12.18%,13.98%,8.09%,9.49%,2.48%。结论城市地区先天畸形的影响因素具有多元性,并以环境因素为主;应针对重点干预因素开展人群干预,以提高出生人口素质。更多还原

【Abstract】 AIM:To study the influencing factors related to the incidence of congenital malformation,which can seriously affect the diathesis of populations,and the intensity of the factors(risk and preventive values) in urban areas,so as to provide scientific evidence for the practical and feasible community intervention program of the disease.METHODS:A 1:1 matched case control study was performed in 169 patients with congenital malformation,including dissection and structural deformation and excluding metabolic and functional disorder,diagnosed according to the criteria of WHO gathered by cluster sampling in Shandong urban areas.Normal perinatal babies were selected as controls according to the same gender, area and birth date(±2 months).The investigation with the same questionnaire and detection of serology were performed in the parents(investigated subjects) of the studies subjects.All the data were analyzed with simple and multiple Logistic regression models,and the intensity and preventive value of the indexes as the influencing factors were calculated.RESULTS:The influencing factors of congenital anomaly were long period from pregnancy to be known(OR=5.490),fever(OR=3.352),taking febricide and anodyne(OR=3.501) and exposure to hazardous chemicals(OR=3.147) during early pregnancy,paternal exposure to injurants(OR=4.495) and negative life events stimulus(OR=1.113).The AR%values of the above factors were 81.78%,70.16%,71.43%,68.22%,77.75%and 10.15%,respectively,and the PAR%values were 13.91%,12.18%,13.98%,8.09%,9.49%and 2.48%,respectively.CONCLUSION:The influencing factors of congenital malformation in urban area are of diversity,and the main factor was environmental factor.The major intervention measures should be chosen according to the intensity of the influencing factors for congenital malformation in order to improve the quality of birth population.更多还原