国内围产儿出生缺陷影响因素的meta分析

doi:10. 13217/j. scjpm. 2019. 0233

摘要/Abstract

摘要： 目的探讨国内围产儿出生缺陷主要影响因素,为今后出生缺陷制定预防控制决策提供依据。方法通过检索中国知网、维普、Pubmed等相关数据库,收集1998—2018年国内外公开发表的关于中国围产儿出生缺陷影响因素的病例对照研究文献,应用Revman 5.3.5统计软件对纳入文献进行meta分析。结果本研究共收集近20年内国内发表的有关文献12篇,文献质量评价得分均≥7分,均为高质量研究。综合分析表明,各影响因素合并的OR值为：孕期患病3.25,孕期合并症及并发症2.02,孕期接触有害物质3.44,孕出生缺陷史3.28,有流产史3.27,孕妇先天性疾病史2.13,家庭附近有污染3.99,孕妇吸烟伴/或不伴饮酒2.12,家庭收入高0.42,有孕检0.43,有婚检0.47。结论孕期患病、孕期合并症及并发症、孕期接触有害物质、孕出生缺陷史、有流产史、孕妇先天性疾病史、家庭附近有污染、孕妇吸烟伴或不伴饮酒是国内常见出生缺陷的主要危险因素;家庭收入高、有孕检及有婚检为保护因素。

关键词: 出生缺陷, 婴儿, 因素分析, 统计学, Meta分析

Abstract: Objective To analyze the risk factors of birth defects in neonates in China so as to provide evidence for future prevention. Methods Relevant databases such as CNKI, VIP and Pubmed were searched for case-control study papers on influencing factors of birth defects in China published from 1998 to 2018. Meta-analysis of included literatures was performed using Revman 5.3.5 statistical software. Results Twelve qualified articles published in China in the past 20 years were collected and their scores of literature quality evaluation were all greater than 7 and hence were of high quality. The OR values of influencing factors were 3.25 for illness during pregnancy, 2.02 for pregnancy complications, 3.44 for exposure to harmful substances, 3.28 for past birth defects history, 3.27 for abortion, 2.13 for congenital diseases, 3.99 for pollution near the house, 2.12 for mothers smoking with or without alcohol consumption, 0.42 for higher family income, 0.43 for pregnancy examination, and 0.47 for premarital check-up. Conclusion Main risk factors for common birth defects in China were pregnancy illness, pregnancy complications, exposure to harmful substances during pregnancy, history of pregnancy and birth defects, history of abortion, congenital diseases of pregnant women, pollution near the house, and smoking or drinking. Higher family income, pregnancy screening and premarital check-up were protective factors.

Key words: Birth defects, Infant, Factor analysis, statistical, Meta-analysis

中图分类号:

R714.7

江石丰, 郑雪婷, 张惠英, 刘然然, 程晋鹏. 国内围产儿出生缺陷影响因素的meta分析[J]. 华南预防医学, 2019, 45(3): 233-236.

JIANG Shi-feng, ZHENG Xue-ting, ZHANG Hui-ying, LIU Ran-ran, CHENG Jin-peng.. Factors influencing perinatal birth defects in China： a meta-analysis[J]. South China Journal of Preventive Medicine, 2019, 45(3): 233-236.

参考文献

[1] 李竹,钱宇平.出生缺陷监测 [M].2版.北京:人民卫生出版社,1993:1.
[2] 凌寒. 卫生部发布《中国出生缺陷防治报告(2012)》[J].中国当代医药,2012,19(28):1.
[3] 万素馨,罗亚玲,周天津.我国出生缺陷影响因素的meta分析[J].重庆医学,2015,44(14):1939-1941.
[4] 曹悦. 太原市迎泽区围产儿出生缺陷影响因素研究及护理干预[D].太原:山西医科大学,2017.
[5] Wells GA,Shea B,O＇Connell D,et a1.The Newcastle-Ottawa Scale(NOS) for assessing the quality of nonrandomised studies in meta-analyses[EB / OL].[2014-01-01]. http: / / www.ohri.ca / programs / clinical_epidemiology / oxford.asp.
[6] 翟俊瑶,宋晖,李芬.西安市三区2010至2014年围产儿出生缺陷影响因素分析[J].中国妇幼健康研究,2017,28(7):805-809.
[7] 程虹,韦月颜,郭艳艳.海口市某医院围生儿出生缺陷发生率及其影响因素的病例对照研究[J]. 职业与健康,2015,31(10):1344-1346,1349.
[8] 刘湘红,曾萼,丘小霞,等.广西高发出生缺陷发生的影响因素分析[J].广西医学,2015,37(8):1085-1088,1092.
[9] 李绚,赵晓骁,陈温容.广州市天河区出生缺陷相关因素的病例对照研究[J].东南大学学报(医学版),2014,33(3):338-342.
[10] 李媛媛,张海鲲,李忠良,等.围产儿出生缺陷影响因素的病例对照研究[J].中国优生与遗传杂志,2011,19(7):96-97,72.
[11] 周凤荣,陈志欣,张蓬,等.山东省围产儿出生缺陷危险因素的病例对照研究[J].中国儿童保健杂志,2005,13(5):398-400,460.
[12] 王香丽,雷方良,屈鹏飞,等.生理相关因素对出生缺陷影响的病例对照研究[J].中国妇幼健康研究,2016,27(6):715-717,751.
[13] 杨华. 围产儿出生缺陷的相关危险因素分析[J].中国医学创新,2014,11(14):75-77.
[14] 王政,方俊群.出生缺陷影响因素的病例对照研究[J].实用预防医学,2009,16(3):679-682.
[15] 张琴,刘奎兰,赵雪芬,等.105例出生缺陷影响因素分析[J].安徽预防医学杂志,2015,21(4):260-262,280.
[16] 王艳玲,王秀梅.盐城地区围产儿出生缺陷相关影响因素分析[J].中国优生与遗传杂志,2014,22(12):90-92,136.
[17] 郭玉琪,郝玉娟,孙利环,等.围产儿出生缺陷相关因素分析[J].中国妇幼保健,2012,27(33):5315-5318.
[18] Nazarpour S, Ramezani Tehrani F, Simbar M, et al.Thyroid dysfunction and pregnancy outcomes[J].Iran J Reprod Med,2015,13(7):387-396.
[19] Iwama N,Metoki H,Ohkubo T,et al.Maternal clinic and home blood pressure measurements during pregnancy and infant birth weight: the BOSHI study[J].Hypertens Res,2016,39(3) : 151-157.
[20] Gabbay-Benziv R,Reece EA,Wang F,et al.Birth defects in pregestational diabetes: defect range, glycemic threshold and pathogenesis[J]. World J Diabetes,2015,6(3) : 481-488.
[21] 刘欣燕,边旭明,韩京秀,等.早期自然流产孕妇生活环境中的危险因素[J].中国医学科学院学报,2007,29(5) : 641-644.
[22] 苏花莉,夏红卫,韦红卫,等.195 例出生缺陷原因调查分析[J].广西医学,2014,43(5):674-676.