CAJ | 학술논문

[目的]探讨中枢神经系统(CNS)出生缺陷的相关因素,为制定预防CNS出生缺陷干预措施提供参考依据.[方法]收集1997年1月至2006年12月期间孕满28周至产后7d的孕产妇89147例,其中确诊为CNS先天畸形患儿115例的母亲为病例组,按1:2配对,选取同等条件的230例正常新生儿的母亲为对照组,进行问卷调查、配对研究.[结果]先天畸形家族史、父接触化学物品、父饮酒指数、感冒发烧、孕期接触农药、被动吸烟是CNS出生缺陷主要危险因素,OR值分别为14.50、10.10、5.00、4.53、3.89、1.76;文化程度,孕中期B超,服用叶酸是保护因素,其βj值分别为-0.48、-2.36、-2.51且OR＜1.病例组及对照组出生缺陷知识问卷得分比较差异有统计学意义(P<0.01),病例组调查对象缺陷儿出生前后对出生缺陷认知的变化比较差异有显著性(P<0.01),正常组分娩前后对出生缺陷认知的变化比较差异无显著性(P>0.05).[结论]做好婚前健康教育及孕期保健,对高危人群做好医学监则,是进一步减少中枢神经系统出生缺陷的关键.
[목적]탐토중추신경계통(CNS)출생결함적상관인소,위제정예방CNS출생결함간예조시제공삼고의거.[방법]수집1997년1월지2006년12월기간잉만28주지산후7d적잉산부89147례,기중학진위CNS선천기형환인115례적모친위병례조,안1:2배대,선취동등조건적230례정상신생인적모친위대조조,진행문권조사、배대연구.[결과]선천기형가족사、부접촉화학물품、부음주지수、감모발소、잉기접촉농약、피동흡연시CNS출생결함주요위험인소,OR치분별위14.50、10.10、5.00、4.53、3.89、1.76;문화정도,잉중기B초,복용협산시보호인소,기βj치분별위-0.48、-2.36、-2.51차OR＜1.병례조급대조조출생결함지식문권득분비교차이유통계학의의(P<0.01),병례조조사대상결함인출생전후대출생결함인지적변화비교차이유현저성(P<0.01),정상조분면전후대출생결함인지적변화비교차이무현저성(P>0.05).[결론]주호혼전건강교육급잉기보건,대고위인군주호의학감칙,시진일보감소중추신경계통출생결함적관건.
[Objective] To discuss the correlation factors of birth defects of central nervous system(CNS) in the area of Dongting Lake, and to provide the references for establishing intervention measures to prevent birth defects of CNS. [Methods] Among 89147 pregnant women who had been pregnant for at least 28 weeks and delivered after 7 days during the period from January 1997 to December 2006, mothers of 115 children patients who were confirmed to suffer from congenital malformation of CNS were collected as the case group. According to 1:2 matched, mothers of 230 normal newborns with the same condition were chosen as comparison group. Then, questionnaire investigation and match research were conducted. [Results] Family history of congenital malformation, father touching chemicals, fathers' drinking index, fever caused by cold, touching pesticide during pregnancy, smoking passively were main dangerous factors of birth defects of CNS, with OR value of 14.50, 10.10, 5.00, 4.53, 3.89 and 1.76, respectively. Education level, B-ultrasound in the middle of pregnancy and taking folic acid were protection factors, with βj value of -0.48, -2.36 and -2.51, respectively and OR value less than 1. The difference between scores of questionnaire of knowledge of birth defects obtained by patient case group and comparison group had statistical significance (P<0.01). For the case group, the change of recognizing birth defects from the before to after the birth of defective newborns was significant (P<0.01). For the normal group, the change from the before to after delivery was not significant (P>0.05). [Conclusion]Doing pre-marriage health education and pregnancy health care, and medically monitoring high risk population are keys to further reduce birth defects of CNS.