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泰国人群中与先天性心脏病相关的父母风险因素:多变量分析。

Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis.

作者信息

Suwansumrit Chayamon, Jittham Worawan

机构信息

Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand.

出版信息

Asian Biomed (Res Rev News). 2021 Dec 30;15(6):267-276. doi: 10.2478/abm-2021-0033. eCollection 2021 Dec.

Abstract

BACKGROUND

Congenital heart diseases (CHDs) are the most common types of birth defects and contribute to a large proportion of infant morbidities and mortalities worldwide. These defects may require multiple surgical interventions impacting the infant's quality of life.

OBJECTIVES

To identify risk factors associated with CHD in a population of Thai children.

METHODS

We conducted a case-control study of patients attending the Pediatric Clinic, Naresuan University Hospital, Thailand. We included data from pediatric patients diagnosed with CHDs as cases, and patients without cardiovascular abnormalities as controls. Risk data were collected from July 2019 to April 2020 using face-to-face interviews. Multiple logistic regression was used to analyze parental factors associated with CHDs.

RESULTS

We included 249 cases classified into 2 groups according to severity and 304 patients as controls. For those less-severely affected (155 patients, 62.2%), ventricular septal defect (27.7%) was the most prevalent, whereas for those with severe CHDs, tetralogy of Fallot was the most prevalent (14.0%). There was no difference in sex distribution or maternal obstetric history between the groups. In multivariable analysis, a family history of CHDs (adjusted odds ratio [AOR] 4.67, 95% confidence interval (CI) 1.61-13.57, = 0.005) and maternal exposure to second-hand cigarette smoke (AOR 1.58, 95% CI 1.03-2.42, = 0.002) were identified as significant risk factors for CHDs.

CONCLUSION

A family history of CHDs and maternal exposure to second-hand cigarette smoke are associated with having offspring with CHDs in the population studied. These findings help us to encourage affected parents to obtain a fetal echocardiogram.

摘要

背景

先天性心脏病(CHD)是最常见的出生缺陷类型,在全球范围内导致很大比例的婴儿发病和死亡。这些缺陷可能需要多次手术干预,影响婴儿的生活质量。

目的

确定泰国儿童群体中与先天性心脏病相关的危险因素。

方法

我们对泰国那黎宣大学医院儿科门诊的患者进行了一项病例对照研究。我们纳入了被诊断为先天性心脏病的儿科患者的数据作为病例,以及没有心血管异常的患者作为对照。2019年7月至2020年4月通过面对面访谈收集风险数据。采用多因素逻辑回归分析与先天性心脏病相关的父母因素。

结果

我们纳入了249例病例,根据严重程度分为2组,304例患者作为对照。对于病情较轻的患者(155例,62.2%),室间隔缺损最为常见(27.7%),而对于患有严重先天性心脏病的患者,法洛四联症最为常见(14.0%)。两组之间的性别分布或母亲产科病史没有差异。在多变量分析中,先天性心脏病家族史(调整后的优势比[AOR]为4.67,95%置信区间[CI]为1.61 - 13.57,P = 0.005)和母亲接触二手烟(AOR为1.58,95% CI为1.03 - 2.42,P = 0.002)被确定为先天性心脏病的重要危险因素。

结论

在所研究的人群中,先天性心脏病家族史和母亲接触二手烟与生育患有先天性心脏病的后代有关。这些发现有助于我们鼓励受影响的父母进行胎儿超声心动图检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/189d/10321219/b6ce76158eaf/j_abm-2021-0033_fig_001.jpg

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