惠州市高危儿脑性瘫痪危险因素分析
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摘要
目的探讨惠州市高危儿发生脑性瘫痪(简称脑瘫)的危险因素,为降低本地区脑瘫的发病率提供依据。方法对2014年3月至2015年9月在惠州出生的1028例高危儿进行2年的随访,其中64例被确诊为脑瘫,按1:4的比例选取同时期出生的健康儿童(n=256)进行匹配,运用单因素和多因素Logistic回归分析,筛查出导致高危儿发生脑瘫的危险因素。结果脑瘫的独立危险因素分别为:既往不良孕产史(OR=2.860,95%CI=1.285～6.368)、保胎史(OR=4.165,95%CI=1.931～8.686)、胎盘异常(OR=3.683,95%CI=1.679～8.077)、辅助生殖妊娠(OR=3.960,95%CI=1.559～10.062)、妊娠期生活环境污染(OR=3.834,95%CI=1.009～14.566)、早产(OR=3.222,95%CI=1.511～6.869)、窒息(OR=2.410,95%CI=1.100～5.278)、高胆红素血症(OR=2.348,95%CI=1.163～5.148)。产检次数大于7次(OR=4.327,95%CI=1.148～12.722)为保护因素。结论在脑瘫的独立危险因素中,5个与孕母相关,3个与新生儿相关,提升本地区的围产期保健水平是降低脑瘫发病率的关键。
Objective To investigate the risk factors for cerebral palsy in high-risk children in Huizhou,and to provide evidence for reducing the incidence of cerebral palsy in this area.MethodsA total of 1028 high-risk children born in Huizhou between March 2014 and September 2015 were followed up for 2 years,and 64 of them were diagnosed with cerebral palsy.In addition,256 healthy children born in the same period were selected as the controls.Univariate and multivariate logistic regression analyses were used to screen the risk factors for cerebral palsy.Results The independent risk factors for cerebral palsy included previous adverse pregnancy outcome(OR=2.860,95%CI=1.285-6.368),miscarriage prevention history(OR=4.165,95%CI=1.931-8.686),placental abnormality(OR=3.683,95%CI=1.679-8.077),assisted reproductive pregnancy(OR=3.960,95%CI=1.559-10.062),environmental pollution during pregnancy(OR=3.834,95%CI=1.009-14.566),premature birth(OR=3.222,95%CI=1.511-6.869),asphyxia(OR=2.410,95%CI=1.100-5.278),and hyperbilirubinemia(OR=2.348,95%CI=1.163-5.148).Prenatal examination more than 7 times was a protective factor for cerebral palsy(OR=4.327,95%CI=1.148-12.722).Conclusion Among the independent risk factors for cerebral palsy,5 are related to pregnant mothers,and 3 to newborns.Therefore,the improvement in perinatal health care is the key to reduce the incidence of cerebral palsy in Huizhou.
Objective To investigate the risk factors for cerebral palsy in high-risk children in Huizhou,and to provide evidence for reducing the incidence of cerebral palsy in this area.MethodsA total of 1028 high-risk children born in Huizhou between March 2014 and September 2015 were followed up for 2 years,and 64 of them were diagnosed with cerebral palsy.In addition,256 healthy children born in the same period were selected as the controls.Univariate and multivariate logistic regression analyses were used to screen the risk factors for cerebral palsy.Results The independent risk factors for cerebral palsy included previous adverse pregnancy outcome(OR=2.860,95%CI=1.285-6.368),miscarriage prevention history(OR=4.165,95%CI=1.931-8.686),placental abnormality(OR=3.683,95%CI=1.679-8.077),assisted reproductive pregnancy(OR=3.960,95%CI=1.559-10.062),environmental pollution during pregnancy(OR=3.834,95%CI=1.009-14.566),premature birth(OR=3.222,95%CI=1.511-6.869),asphyxia(OR=2.410,95%CI=1.100-5.278),and hyperbilirubinemia(OR=2.348,95%CI=1.163-5.148).Prenatal examination more than 7 times was a protective factor for cerebral palsy(OR=4.327,95%CI=1.148-12.722).Conclusion Among the independent risk factors for cerebral palsy,5 are related to pregnant mothers,and 3 to newborns.Therefore,the improvement in perinatal health care is the key to reduce the incidence of cerebral palsy in Huizhou.
引文
[1] 刘湘云,陈荣华,赵正言.儿童保健学[M].4版.南京:江苏科学技术出版社,2011:110-115.
[2] 李晓捷,唐久来,马丙祥.脑性瘫痪的定义、诊断标准及临床分型[J].中华实用儿科临床杂志,2014,29(19):1520.
[3] 李晓捷,邱洪斌,姜志梅,等.中国十二省市小儿脑性瘫痪流行病学特征[J].中华实用儿科临床杂志,2018,33(5):378-383.
[4] 邵肖梅,周文浩.胎儿和新生儿脑损伤[M].2版.上海:上海科技教育出版社,2017:665-667.
[5] 王军,马洁琼,朱登纳,等.河南省脑性瘫痪儿童危险因素分析[J].中华实用儿科临床杂志,2014,29(7):536-539.
[6] 徐晓莉,肖农,赵阳.脑瘫研究的一些新进展[J].中华物理医学与康复杂志,2012,34(5):393-395.
[7] 张慧娟,徐月英.胎盘病理诊断及研究进展[J].实用妇产科杂志,2015,11(31):801-803.
[2] 李晓捷,唐久来,马丙祥.脑性瘫痪的定义、诊断标准及临床分型[J].中华实用儿科临床杂志,2014,29(19):1520.
[3] 李晓捷,邱洪斌,姜志梅,等.中国十二省市小儿脑性瘫痪流行病学特征[J].中华实用儿科临床杂志,2018,33(5):378-383.
[4] 邵肖梅,周文浩.胎儿和新生儿脑损伤[M].2版.上海:上海科技教育出版社,2017:665-667.
[5] 王军,马洁琼,朱登纳,等.河南省脑性瘫痪儿童危险因素分析[J].中华实用儿科临床杂志,2014,29(7):536-539.
[6] 徐晓莉,肖农,赵阳.脑瘫研究的一些新进展[J].中华物理医学与康复杂志,2012,34(5):393-395.
[7] 张慧娟,徐月英.胎盘病理诊断及研究进展[J].实用妇产科杂志,2015,11(31):801-803.