【摘要】 目的:了解以社区为基础的出生缺陷发生水平和有关影响因素,为出生缺陷的预防和孕期保健提供依据。方法:采用多阶段分层整群抽样方法,从我国东、中、西部地区9个中等发达省份中各抽取1个国家人口计生委信息采集抽样县,每个县抽取2个乡镇,再从中各抽取2～4个居委(村),调查其中所有已婚育龄妇女≤9岁子女的出生缺陷发生及相关信息,通过单因素分析和多元logistic回归分析,探讨出生缺陷的影响因素。结果:调查对象共3958例,出生缺陷发生率为1.80%。单因素卡方检验发现母亲产龄、文化程度、流产史、孕期微量营养素补充、产检机构与出生缺陷发生有关(P<0.05)。多元logistic回归分析显示,产龄16～20岁(OR=2.53,95%CI:1.25～5.10)、有人工流产史(OR=3.32,95%CI:1.69～6.51)、吸烟(OR=3.34,95%CI:1.04～10.75)、孕期未补充微量元素(OR=1.84,95%CI:1.07～3.16)、在乡镇及以下机构产前检查(OR=1.70,95%CI:1.06～2.74)的母亲生育出生缺陷儿的危险较高。结论:出生缺陷预防干预应重点关注既往有人工流产史、低龄、吸烟孕妇对象,重视基层产前检查机构服务能力建设,提供优质孕期监测与营养保健咨询服务。更多还原

【Abstract】 Objective: To explore the prevalence and risk factors for birth defects (BD) among children in 9 provinces of China. Methods: By using stratified, random cluster sampling methods, 17 townships and 36 rural villages and urban neighbourhood were sampled from 9 provinces of China. All married women aged between 20 - 49 years old were investigated and a questionnaire survey on birth defects of their children under 9 year-old was conducted. Chi-square test and multivariate logistic regression analysis were used to evaluate the association between BD and maternal risk factors. Results: There were 3 958 respondents, and the prevalence of BD was 1.80%. Results of chi-square tests indicated that maternal age, education level, history of abortion, micro-nutrients supplementation during pregnancy, and hospital grade for pregnancy check-up were associated with the likelihood of BD (P<0.05). Logistic regression analysis showed that mothers aged 16 to 20 (OR=2.53, 95%CI: 1.25-5.10), those with a history of abortion (OR=3.32, 95%CI: 1.69-6.51), smoking during pregnancy (OR=3.34, 95%CI: 1.04-10.75), without micro-nutrients supplementation during pregnancy (OR=1.84, 95%CI: 1.07-3.16), and performing pregnancy check-up at township hospital or below (OR=1.70, 95%CI: 1.06-2.74) were associated with significantly higher risks of BD. Conclusion: Women with a history of abortion, being pregnant at very young age, or having a habit of smoking should be the focus of BD prevention. It is helpful to enhance the service capability of pregnancy health check-up at primary maternity hospitals and provide high quality of antenatal examinations to decline the likelihood of BD.更多还原