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受孕前后因素影响后代神经管缺陷风险:一项基于中国医院的病例对照研究。

Periconceptional factors affect the risk of neural tube defects in offspring: a hospital-based case-control study in China.

作者信息

Wang Meng, Wang Zhi-Ping, Gao Li-Jie, Gong Rui, Zhang Meng, Lu Qing-Bin, Zhao Zhong-Tang

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, Shandong, China.

出版信息

J Matern Fetal Neonatal Med. 2013 Jul;26(11):1132-8. doi: 10.3109/14767058.2013.770461. Epub 2013 Mar 1.

Abstract

OBJECTIVE

To explore the periconceptional factors affecting the risk of neural tube defects (NTDs), we carried out a hospital-based case-control study in China.

METHODS

A 1:1 matched case-control study was conducted. With self-designed questionnaires, we solicited relevant information from 459 case mothers and 459 control mothers selected in two provinces of China through face-to-face interviews. Univariate and multivariate conditional logistic regression analyses were conducted to evaluate the effect values by odds ratios (ORs) and 95% confidence intervals (95%CIs) with SAS9.1.3.software.

RESULTS

Daily passive tobacco smoke exposure was a risk factor for total NTDs (OR = 8.688, 95%CI = 2.329-32.404). Diet adjustment in the first trimester (OR = 0.061, 95%CI = 0.014-0.274), periconceptional folic acid intake (OR = 0.059, 95%CI = 0.011-0.321) and health education (OR = 0.251, 95%CI = 0.081-0.781) were protective factors for total NTDs. Differences in factors and their effects on NTDs were found for the three subtypes of NTDs: anencephaly, spina bifida and encephalocele.

CONCLUSIONS

Daily passive tobacco smoke exposure, diet adjustment in the first trimester, periconceptional folic acid intake and health education were associated with NTDs.

摘要

目的

为探讨影响神经管缺陷(NTDs)风险的受孕前后因素,我们在中国开展了一项基于医院的病例对照研究。

方法

进行了一项1:1匹配的病例对照研究。通过自行设计的问卷,我们对在中国两个省份选取的459例病例母亲和459例对照母亲进行面对面访谈,收集相关信息。使用SAS9.1.3软件,通过单因素和多因素条件logistic回归分析,以比值比(OR)和95%置信区间(95%CI)评估效应值。

结果

每日被动吸烟是总神经管缺陷的一个危险因素(OR = 8.688,95%CI = 2.329 - 32.404)。孕早期饮食调整(OR = 0.061,95%CI = 0.014 - 0.274)、受孕前后叶酸摄入(OR = 0.059,95%CI = 0.011 - 0.321)和健康教育(OR = 0.251,95%CI = 0.081 - 0.781)是总神经管缺陷的保护因素。在神经管缺陷的三种亚型:无脑儿、脊柱裂和脑膨出中,发现了因素及其对神经管缺陷影响的差异。

结论

每日被动吸烟、孕早期饮食调整、受孕前后叶酸摄入和健康教育与神经管缺陷有关。

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