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中国儿童患脑瘫的风险:一项N:M匹配病例对照研究。

Risk of cerebral palsy in Chinese children: A N:M matched case control study.

作者信息

Gao Jing, Zhao Bin, He Luna, Sun Meiling, Yu Xuefeng, Wang Lina

机构信息

Children Rehabilitation Center of Huaian Maternity and Child Care Hospital, Huaian, China.

The Fourth Affiliated Hospital of Nanchang University, Nanjing, China.

出版信息

J Paediatr Child Health. 2017 May;53(5):464-469. doi: 10.1111/jpc.13479. Epub 2017 Jan 30.

Abstract

AIM

To estimate epidemiological risk factors for cerebral palsy (CP) in children.

METHODS

A N:M matched case control study was conducted in 114 persons with CP and 1286 controls. Relevant data were collected using a maternal self-design questionnaire. Univariate logistic regression and multivariate conditional logistic regression analyses were performed using SPSS.

RESULTS

Univariate analysis has yielded 20 significant risk factors for CP. Advanced maternal age (30 years or older) at childbirth (adjusted odds ratio (OR) 1.63, 95% confidence interval (CI) 0.98-2.72), alcohol consumption during pregnancy (adjusted OR 4.17, 95% CI 1.23-14.08), living in the countryside (adjusted OR 1.71, 95% CI 1.18-2.48), father's occupational exposure to harmful substances (adjusted OR 3.34, 95% CI 1.61-6.93) and multiple births (adjusted OR 3.10, 95% CI 1.65-5.84) were found to be risk factors for CP by multivariate analysis. On the other side, high mother's education level (adjusted OR 0.60, 95% CI 0.46-0.76), folic acid supplements (adjusted OR 0.50, 95% CI 0.30-0.82), and high birth hospital level (adjusted OR 0.68, 95% CI 0.52-0.90) were found to be protective factors.

CONCLUSION

Although the important risk factors of CP focus on gestation at birth and perinatal events, the incidence could probably be further lowered, if potential risk factors identified in this study are considered.

摘要

目的

评估儿童脑瘫(CP)的流行病学危险因素。

方法

对114例脑瘫患儿和1286名对照者进行1:N匹配的病例对照研究。使用母亲自行设计的问卷收集相关数据。采用SPSS进行单因素逻辑回归和多因素条件逻辑回归分析。

结果

单因素分析得出20个脑瘫的显著危险因素。多因素分析发现,产妇高龄(分娩时30岁及以上)(调整比值比(OR)1.63,95%置信区间(CI)0.98 - 2.72)、孕期饮酒(调整OR 4.17,95% CI 1.23 - 14.08)、居住在农村(调整OR 1.71,95% CI 1.18 - 2.48)、父亲职业接触有害物质(调整OR 3.34,95% CI 1.61 - 6.93)和多胎妊娠(调整OR 3.10,95% CI 1.65 - 5.84)是脑瘫的危险因素。另一方面,母亲高学历(调整OR 0.60,95% CI 0.46 - 0.76)、补充叶酸(调整OR 0.50,95% CI 0.30 - 0.82)和出生医院级别高(调整OR 0.68,95% CI 0.52 - 0.90)是保护因素。

结论

虽然脑瘫的重要危险因素集中在出生孕周和围产期事件,但如果考虑本研究中确定的潜在危险因素,其发病率可能会进一步降低。

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