杭州市余杭区育龄妇女生育间隔与新生儿出生缺陷发生率的相关性分析
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摘要
目的探讨杭州市余杭区育龄妇女生育间隔与新生儿出生缺陷发生率的相关性。方法于患者住院期间,以调查问卷形式收集孕妇及新生儿基本信息。按照纳入排除标准确定研究对象。采用Logistic回归分析对生育间隔与出生缺陷的关系进行分析,并控制各类混杂因素。结果共19 784名产妇及其19 784名新生儿纳入本研究,作为研究对象。发现出生缺陷的新生儿162名,出生缺陷发生率为8. 19‰。组间比较发现,生育间隔(IPI)对新生儿出生缺陷有影响。采用Logistic回归校正混杂因素后发现,IPI <12个月(OR=1. 47,95%CI 1. 22-1. 75)为先天性心脏病发生的危险因素,12≤IPI <24个月(OR=1. 21,95%CI 1. 02-1. 28)和IPI <12个月(OR=1. 88,95%CI 1. 31-2. 78)为唇腭裂发生的危险因素。结论①选择合适的出生间隔可以有效降低新生儿出生缺陷。②年龄小于35岁的育龄妇女,建议生育间隔应≥12个月。
Objective To investigate the correlation between the interpregnancy interval of women and birth defects in Yuhang District of Hangzhou. Methods The basic information of pregnant women and newborns was collected by questionnaire during the hospitalization of patients. Subjects were enrolled according to inclusion and exclusion criteria. Logistic regression analysis was used to analyze the relationship between birth spacing and birth defects after confounding factors were controlled. Results A total of 19 784 maternal women and their 19 784 newborns were included in the study. A total of 162 newborns with birth defects were found,and the incidence of birth defects was 8. 19‰. The incidence of birth defects was different in pregnancy with different interpregnancy interval. Multivariate Logistic regression showed that IPI < 12 months( OR = 1. 47,95% CI 1. 22-1. 75) was a risk factor for congenital heart disease after correcting the confounding factors,12≤IPI < 24 months( OR = 1. 21,95% CI 1. 02-1. 28) and IPI < 12 months( OR = 1. 88,95%CI 1. 31-2. 78) were risk factors for cleft lip and palate. Conclusion ①A suitable birth interval can effectively reduce birth defects in newborns. ②For women of childbearing aged younger than 35 years,it is recommended that the birth spacing should be greater than or equal to 12 months.
Objective To investigate the correlation between the interpregnancy interval of women and birth defects in Yuhang District of Hangzhou. Methods The basic information of pregnant women and newborns was collected by questionnaire during the hospitalization of patients. Subjects were enrolled according to inclusion and exclusion criteria. Logistic regression analysis was used to analyze the relationship between birth spacing and birth defects after confounding factors were controlled. Results A total of 19 784 maternal women and their 19 784 newborns were included in the study. A total of 162 newborns with birth defects were found,and the incidence of birth defects was 8. 19‰. The incidence of birth defects was different in pregnancy with different interpregnancy interval. Multivariate Logistic regression showed that IPI < 12 months( OR = 1. 47,95% CI 1. 22-1. 75) was a risk factor for congenital heart disease after correcting the confounding factors,12≤IPI < 24 months( OR = 1. 21,95% CI 1. 02-1. 28) and IPI < 12 months( OR = 1. 88,95%CI 1. 31-2. 78) were risk factors for cleft lip and palate. Conclusion ①A suitable birth interval can effectively reduce birth defects in newborns. ②For women of childbearing aged younger than 35 years,it is recommended that the birth spacing should be greater than or equal to 12 months.
引文
[1]赵豆豆,戴亚欣,郭乐倩,等.围孕期患病及心理状态与婴儿出生缺陷的关系[J].中华流行病学杂志,2017,38(11):1460-1465.
[2]杜明钰,马润玫,王明芳,等.昆明地区妇女生育间隔对妊娠结局的影响[J].中国妇幼保健,2015,30(20):3342-3344.
[3]中华人民共和国卫生部.《中国出生缺陷防治报告(2012)》问答[J].中国实用乡村医生杂志,2012,19(20):3-5.
[4]吴怡,程蔚蔚.出生缺陷概况及产前筛查[J].中国计划生育和妇产科,2016,8(1):29-33.
[5]成胜权.出生缺陷及常见出生缺陷早期诊断和干预[J].发育医学电子杂志,2015,3(1):1-7.
[6] Oster ME,Riehle-Colarusso T,Alverson CJ. et al. Associations Between Maternal Fever and Influenza and Congenital Heart Defects[J]. J Pediatr,2010,158(6):990-995.
[7] Suarez L,Cardarelli K,Hendricks K. Maternal stress,social support,and risk of neural tube defects among Mexican Americans.[J]. Epidemiology,2003,14(5):612-616.
[8]修新红,袁丽,王晓明,等.出生缺陷影响因素的病例对照研究[J].中华妇产科杂志,2011,46(7):481-486.
[9]张翠玲,刘鸿雁.中国生育间隔政策的历史变动分析[J].南方人口,2016,31(06):40-56.
[10]章琦,王玲玲,柏如海,等.育龄妇女生育间隔与活产单胎新生儿出生体重的关联分析[J].中华流行病学杂志,2018,39(3):317-321.
[11] Howard EJ,Harville E,Kissinger P,et al. The association between short interpregnancy interval and preterm birth in louisiana:a comparison of methods[J]. Matern Child Health J,2013,17(5):933-939.
[12] Wendt A,Gibbs CM,Peters S,et al. Impact of increasing interpregnancy interval on maternal and infant health[J]. Paediatr Perinat Epidemiol,2012,26(1):239-258.
[13] Conde-Agudelo A,Rosas-Bermudez A,Castao F,et al. Effects of birth spacing on maternal,perinatal,infant,and child health:a systematic review of causal mechanisms[J]. Stu Fam Plann,2012,43(2):92-114.
[14] Shachar BZ,Lyell DJ. Interpregnancy interval and obstetrical complications[J]. Obstet Gynecol Surv,2012,67(9):584-596.
[15] Li N,Liu E,Guo J,et al. Maternal prepregnancy body mass index and gestational weight gain on offspring overweight in early infancy[J]. Plo S One,2013,8(10):e77809.
[2]杜明钰,马润玫,王明芳,等.昆明地区妇女生育间隔对妊娠结局的影响[J].中国妇幼保健,2015,30(20):3342-3344.
[3]中华人民共和国卫生部.《中国出生缺陷防治报告(2012)》问答[J].中国实用乡村医生杂志,2012,19(20):3-5.
[4]吴怡,程蔚蔚.出生缺陷概况及产前筛查[J].中国计划生育和妇产科,2016,8(1):29-33.
[5]成胜权.出生缺陷及常见出生缺陷早期诊断和干预[J].发育医学电子杂志,2015,3(1):1-7.
[6] Oster ME,Riehle-Colarusso T,Alverson CJ. et al. Associations Between Maternal Fever and Influenza and Congenital Heart Defects[J]. J Pediatr,2010,158(6):990-995.
[7] Suarez L,Cardarelli K,Hendricks K. Maternal stress,social support,and risk of neural tube defects among Mexican Americans.[J]. Epidemiology,2003,14(5):612-616.
[8]修新红,袁丽,王晓明,等.出生缺陷影响因素的病例对照研究[J].中华妇产科杂志,2011,46(7):481-486.
[9]张翠玲,刘鸿雁.中国生育间隔政策的历史变动分析[J].南方人口,2016,31(06):40-56.
[10]章琦,王玲玲,柏如海,等.育龄妇女生育间隔与活产单胎新生儿出生体重的关联分析[J].中华流行病学杂志,2018,39(3):317-321.
[11] Howard EJ,Harville E,Kissinger P,et al. The association between short interpregnancy interval and preterm birth in louisiana:a comparison of methods[J]. Matern Child Health J,2013,17(5):933-939.
[12] Wendt A,Gibbs CM,Peters S,et al. Impact of increasing interpregnancy interval on maternal and infant health[J]. Paediatr Perinat Epidemiol,2012,26(1):239-258.
[13] Conde-Agudelo A,Rosas-Bermudez A,Castao F,et al. Effects of birth spacing on maternal,perinatal,infant,and child health:a systematic review of causal mechanisms[J]. Stu Fam Plann,2012,43(2):92-114.
[14] Shachar BZ,Lyell DJ. Interpregnancy interval and obstetrical complications[J]. Obstet Gynecol Surv,2012,67(9):584-596.
[15] Li N,Liu E,Guo J,et al. Maternal prepregnancy body mass index and gestational weight gain on offspring overweight in early infancy[J]. Plo S One,2013,8(10):e77809.