【摘要】 目的 :探讨中国 1～ 6岁小儿脑瘫的危险因素 ,为病因和防治措施研究奠定基础。方法 :1997年 5月至1998年 12月在中国江苏等 6个省 (自治区 )对 1～ 6岁小儿脑性瘫痪进行了以人群为基础的 1∶2病例对照研究。结果 :共调查 1～ 6岁儿童 10 4 732 7名 ,发现 1～ 6岁儿童脑瘫病例共 2 0 0 9例 ;对 196 8例脑瘫及其对照者的危险因素研究结果表明 ,脑瘫的危险因素主要包括 2 8个 ,其中分娩前期 15个 ,分娩过程 5个 ,新生儿期 8个 ;新生儿期危险因素包括缺氧缺血性脑病 (OR =2 6 .4 ,95 %CI=4 .6 ,15 2 .2 )、高胆红素脑病 (OR =14 .2 ,95 %CI =5 .3,38.2 )、新生儿脑膜炎 (OR =2 6 7.6 ,95 %CI=2 1.2 ,3372 )和颅内出血 (OR =133.1,95 %CI =2 5 .4 ,6 97.7)等与脑瘫关联最强 ,分娩过程因素其次 ,分娩前因素最弱。分娩前因素包括父母是近亲 (OR =3.1,95 %CI=1.4 ,6 .8)、亲属中有智力低下者 (OR =5 .4 ,95 %CI =3.1,9.4 )、胎儿宫内发育迟缓 (OR =6 .6 ,95 %CI =2 .5 ,16 .7)、出生体重轻 (OR =5 .3,95 %CI =3.2 ,8.9)、出生孕周小 (OR =7.6 ,95 %CI =4 .2 ,13.7)、母孕期服用药品 (OR =7.9,95 %CI =2 .6 ,2 3.2 )等 ,虽然与脑瘫关联程度有限 ,但数目多 ,而且可能与新生儿期危险因素有因果关系。结论 :新生儿期更多还原

【Abstract】 SUMMARY Objective: To evaluate risk factors for childhood cerebral palsy(CP) in China. Methods: We conducted a population based case control study among children in six provinces in China. They were 1-6 years old children with CP Two controls were selected for each child; controls were selected from children of same sex, same age, and living in the same township. Information on pregnancy, labor, delivery, and the neonatal period was obtained. Results: 1 047 327 children aged 1-6 years old were enrolled and 2 009 children of CP were found.Cases were much more likely than controls to experience hypoxic ischemic encephalopathy ( OR = 26.4, 95%CI = 4.6, 152.2 ), hyperbilirubinemia(OR=14.2,95%CI=5.3,38.2), intracranial hemorrhage(OR=133.1,95%CI= 25.4,697.7) , and neonatal meningitis (OR=267.6, 95%CI=21.2,3 372) in the neonatal period. Prenatal or intradelivery factors such as family history of mental retardation(OR=5.4, 95%CI=3.1, 9.4), poor maternal nutrition status(OR=1.9, 95%CI=1.6,2.4), maternal fever(OR=1.9, 95%CI=1.4,2.5) and drug exposure(OR=7.8, 95%CI=2.6,23.2), intrauterine growth retardation(OR=6.6, 95%CI=2.5,16.7), premature labor(OR=7.6, 95%CI=4.2,13.7), and low birth weight(OR=5.3, 95%CI=3.2,8.9); and demographic factors such as poor socioeconomic status(OR= 1.8, 95%CI=1.4,2.5) and exposure to cigarette smoke(OR=1.5, 95%CI=1.1,1.9) were with lower odds ratio. Conclusion: In this study, adverse events occurring during the neonatal period were more strongly associated with development of CP than were prenatal or demographic factors; however, the influence of prenatal or demographic factors on neonatal events needs further study.更多还原