Begić Hidajeta, Tahirović Husref F, Dinarević Senka, Ferković Vesna, Pranjić Nurka
Klinika za djecije bolesti, Univerzitetsko-klinicki centar Tuzla.
Med Arh. 2002;56(2):73-7.
Congenital heart diseases (CHD) are taking high position on the list of neonatal and infant mortality, and they are significantly involved in mortality of children and adults. During cardiogenesis various genetic and non-genetic ethiological factors are starting pathogenetic mechanism what results in developing of CHD. Purpose of research is evaluation of participation of some risk-factors in developing of CHD in children on Tuzla Canton area. This research included 352 children up to 15 years old, in which was discovered CHD during period from 1.1.1994 to 31.12.1999. Using method of anamnestic questionnaire we analyzed data related to occurence of CHD in relatives, reproductive age of mother, mother's illness and taking medications in first trimester of pregnancy, and professional exposure to harmful chemicals. In 24 or 6.81% of cases CHD was registered in one of first-degree relatives, and in only one case in second-degree of relatives. It was noticeable that CHD in highest number of cases (291 or 83.14%) were present in children whose mothers were 20-35 years old, while only 18 or 5.11% of mothers aged 35 and more what is considered as high risk age for development of anomalies in general. In 70 or 20% cases CHD was associated with other systems anomalies, including syndromes and chromosomopathies. Risk-factors related to earlier pregnancies of mothers were found in 40 (11.36%) of children. Data about acute and chronic diseases of mother during pregnancy were found in 36 children. analysis of exposure to harmful chemicals during first trimester of pregnancy is showing that 39 or 11.08% mothers were exposed to nicotine, while 17 or 4.83% were taking medications. Exposure to professional poisoning were found in 5 or 1.42% of cases. Results of research are pointing on need for continued observation genetic and wide range of other potential risk-factors from environment related to development of CHD in our area. This way we could explain some specific characteristic occurrences of CHD in some areas.
先天性心脏病（CHD）在新生儿和婴儿死亡率排行榜上位居前列，并且在儿童和成人死亡率中占显著比例。在心脏发生过程中，各种遗传和非遗传病因因素启动致病机制，导致先天性心脏病的发生。本研究的目的是评估图兹拉州地区某些风险因素在儿童先天性心脏病发生中的作用。本研究纳入了352名15岁以下儿童，他们于1994年1月1日至1999年12月31日期间被发现患有先天性心脏病。我们采用回忆性问卷调查方法，分析了与亲属中先天性心脏病的发生、母亲的生育年龄、母亲在怀孕头三个月的疾病和用药情况以及职业性接触有害化学物质有关的数据。在24例（6.81%）病例中，先天性心脏病在一级亲属中的一人身上被记录，二级亲属中仅有1例。值得注意的是，大多数病例（291例，83.14%）的先天性心脏病出现在母亲年龄为20至35岁的儿童中，而35岁及以上的母亲仅有18例（5.11%），一般认为这个年龄段是发育异常的高风险年龄。在70例（20%）病例中，先天性心脏病与其他系统异常相关，包括综合征和染色体病。在40名（11.36%）儿童中发现了与母亲早期怀孕相关的风险因素。在36名儿童中发现了母亲孕期急慢性疾病的数据。对怀孕头三个月接触有害化学物质的分析表明，39名（11.08%）母亲接触过尼古丁，17名（4.83%）母亲服用过药物。在5例（1.42%）病例中发现了职业中毒暴露情况。研究结果表明，需要继续观察与我们地区先天性心脏病发生相关的遗传因素以及来自环境的其他广泛潜在风险因素。通过这种方式，我们可以解释某些地区先天性心脏病的一些特定特征性发病情况。
