Ou Yanqiu, Mai Jinzhuang, Zhuang Jian, Liu Xiaoqing, Wu Yong, Gao Xiangmin, Nie Zhiqiang, Qu Yanji, Chen Jimei, Kielb Christine, Lauper Ursula, Lin Shao
Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
Pediatr Res. 2016 Apr;79(4):549-58. doi: 10.1038/pr.2015.264. Epub 2015 Dec 17.
Limited studies have evaluated the risk factors for congenital heart defects (CHDs) in China and compared them for different types of CHDs. This study examined risk factors between isolated and multiple CHDs as well as among CHDs subtypes in Guangdong, Southern China.
This population-based case-control study included 4,034 pairs of case and control infants enrolled in the Guangdong Registry of CHD study, 2004-2013. Multivariate logistic regression was used to compute adjusted odds ratios (ORs) while simultaneously controlling for confounders.
Multiple maternal environmental exposures, including living in newly renovated rooms, residential proximity to main traffic, paternal smoking, and maternal occupation as manual worker, were significantly associated with CHDs with ORs ranging 1.30-9.43. Maternal perinatal diseases (including maternal fever, diabetes, influenza, and threatened abortion), maternal medication use (antibiotic use), advanced maternal age, low socioeconomic status, and paternal alcohol intake were also significantly associated with CHDs, with ORs ranging 1.60-3.96. Isolated CHDs and multiple defects have different profiles of risk factors, while subtype of CHD shares common risk factors.
These results suggest that maternal environmental exposures/occupation and perinatal diseases/medication use were dominant risk factors associated with CHDs in Southern China. Isolated and multiple CHDs may have different etiologic factors.
在中国,针对先天性心脏病(CHD)危险因素的研究有限,且不同类型先天性心脏病的危险因素对比研究较少。本研究调查了中国南方广东省单纯性先天性心脏病与复杂性先天性心脏病之间以及先天性心脏病各亚型之间的危险因素。
本基于人群的病例对照研究纳入了2004年至2013年期间在广东省先天性心脏病登记研究中登记的4034对病例组和对照组婴儿。采用多因素logistic回归分析计算校正比值比(OR),同时控制混杂因素。
多种母亲环境暴露因素,包括居住在新装修房间、住所靠近主要交通干道、父亲吸烟以及母亲为体力劳动者,与先天性心脏病显著相关,OR值范围为1.30至9.43。母亲围产期疾病(包括母亲发热、糖尿病、流感和先兆流产)、母亲用药(使用抗生素)、母亲高龄、社会经济地位低下以及父亲饮酒也与先天性心脏病显著相关,OR值范围为1.60至3.96。单纯性先天性心脏病和复杂性先天性心脏病具有不同的危险因素特征,而先天性心脏病各亚型具有共同的危险因素。
这些结果表明,母亲环境暴露/职业以及围产期疾病/用药是中国南方与先天性心脏病相关的主要危险因素。单纯性先天性心脏病和复杂性先天性心脏病可能具有不同的病因。