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山西省神经管缺陷的高患病率:一种综合流行病学方法。

High prevalence of NTDs in Shanxi Province: a combined epidemiological approach.

作者信息

Gu Xue, Lin Liangming, Zheng Xiaoying, Zhang Ting, Song Xinming, Wang Jinfeng, Li Xinhu, Li Peizhen, Chen Gong, Wu Jilei, Wu Lihua, Liu Jufen

机构信息

Capital Institute of Pediatrics, Beijing 100020, China.

出版信息

Birth Defects Res A Clin Mol Teratol. 2007 Oct;79(10):702-7. doi: 10.1002/bdra.20397.

Abstract

BACKGROUND

Shanxi Province has historically reported a high prevalence of NTDs. In order to establish baseline rates for NTDs and discuss the risk factors associated with sociodemographic, maternal characteristics, and geographic factors, we performed the present study using an approach combining population and hospital-based methodologies.

METHODS

We used chi(2) and Fisher's exact tests to evaluate variation in the prevalence by selected covariates and computed crude ORs and 95% CIs. Adjusted odds ratios (AORs) were performed using logistic regression with all the covariates included in the model.

RESULTS

The overall NTD prevalence during the 3 year study period was 199.38 per 10,000 births, with a higher NTD prevalence clustered in 46 villages within this geographic area. However, no statistical significance was found between NTD prevalence and the elevation of the villages or their distance from coal plants. AORs revealed women aged 20 and above had a lower risk of NTDs compared to those younger than 20 (AOR range 0.4-0.5). A higher risk of NTDs was observed among female infants (AOR 1.50; 95% CI: 1.04-2.17), women with four or more previous births (AOR 2.80; 95% CI: 1.20-6.52), and a previous history of birth defects (AOR 3.23; 95% CI: 1.46-7.12).

CONCLUSIONS

This study has documented a high prevalence of NTDs in Shanxi. Similar variations to other reports were found in the risk of NTDs by maternal demographic characteristics and a clustering of NTDs in certain villages that require further exploration.

摘要

背景

山西省历史上报告的神经管缺陷(NTDs)患病率较高。为了确定NTDs的基线发病率,并探讨与社会人口统计学、孕产妇特征和地理因素相关的风险因素,我们采用了基于人群和医院的方法相结合的方式进行了本研究。

方法

我们使用卡方检验和Fisher精确检验来评估选定协变量的患病率差异,并计算粗比值比(ORs)和95%置信区间(CIs)。使用逻辑回归对模型中包含的所有协变量进行调整后的比值比(AORs)分析。

结果

在3年的研究期间,NTDs的总体患病率为每10000例出生199.38例,该地理区域内46个村庄的NTDs患病率较高。然而,未发现NTDs患病率与村庄海拔或其与煤矿的距离之间存在统计学意义。AORs显示,20岁及以上的女性患NTDs的风险低于20岁以下的女性(AOR范围为0.4 - 0.5)。在女婴(AOR 1.50;95% CI:1.04 - 2.17)、有四次或更多次既往分娩史的女性(AOR 2.80;95% CI:1.20 - 6.52)以及有出生缺陷既往史的女性(AOR 3.23;95% CI:1.46 - 7.12)中观察到较高的NTDs风险。

结论

本研究记录了山西省NTDs的高患病率。在NTDs风险方面,通过孕产妇人口统计学特征发现了与其他报告相似的差异,并且在某些村庄存在NTDs聚集现象,需要进一步探索。

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