【作者】 曾小云；

【导师】 仇小强；

【作者基本信息】 广西医科大学 ， 流行病与卫生统计学， 2002， 硕士

【摘要】 目的：为了解广西先天畸形的现状，并探讨广西城区围产儿先天畸形的危险因素，为先天畸形防治措施的制定及开展优生优育工作提供依据。方法：2000年在广西南宁、柳州、桂林、玉林、梧州、钦州、北海七个城市所属62所医院(不包括郊区、县医院)出生41539例围产儿，其中畸形儿共513例，对其中资料较全的281例畸形儿进行了病例对照研究，以单因素、多因素非条件Logistic回归进行分析。结果：七个城市先天畸形总检出率为12.35‰，其中男性为13.32‰，女性为10.48‰，男女之比为1.3:1；七个城市中以梧州市、玉林市检出率较高，北海市较低；城镇先天畸形检出率为12.20‰，乡村(指常住乡村来城市分娩的产妇)检出率为11.55‰，两者标准化检出率无显著性差异；产妇不同年龄组先天畸形标准化检出率无显著性差异；在所检出的各类先天畸形中，以巴氏水肿综合征为最多。单因素及多因素分析结果提示先天畸形的主要危险因素是：胎儿出生体重低(OR=0.999)；多产次(OR=2.6)；有妊娠合并症(OR=3.2)；母亲妊娠前后接触化学制剂(OR=3.0)；孕期服过镇静药(OR=10.2)、激素类药(OR=9.4)、中成药(OR=2.5)；母亲血红蛋白量低(OR=0.985)；父亲接触噪声(OR=5.7)、有慢性病(OR=2.8)；母亲血型为AB型其后代发生先天畸形的危险性是O型的3倍多，A型的是O型的2倍多，B型的是O型的1倍多；母亲孕期情绪紧张、忧郁其后代发生先天畸形的危险性是情绪愉快的2倍多，情绪一般的是情绪愉快的1倍多；母亲 毕业论义；广M七城市闲产儿冗天畸形危险冈素的拖例对照研究职业为工人其后代发生先大畸形的危险性是干部的3倍多，职业为农民的是干部的2倍多，职业为个体的与干部的无显著性差异。结论：对具有或接触以上先天畸形危险因素的重点人群应加强孕期保健，普及优生优育知识，调整饮食结构，孕期尽量避免服一些不利于妊娠的中西药及接触化学制剂，还应保持愉快的心情。所发现的危险因素值得今后深入研究，并可提供优生学保健指导参考。更多还原

【Abstract】 Objective: To investigate the incidence and the possible risk factors of congenital malformations in cities of Guangxi and provide basis for preventing congenital malformations and promoting birth quality. Methods: In 2000, 41539 perinatals were born in 62 hospitals of Nanning, Liuzhou, Guilin, Yulin, Wuzhou, Qinzhou and Beihai city, in which 513 cases of congenital malformations were diagnosed. A case-control study with 281 cases was carried out. Analysis of simple factor and multiple factors unconditional logistic regression was taken. Results: In all seven cities the total incidence of congenital malformations was 12.35%o, 13.32%o in male and 10.48%o in female with the sex ratio of 1.3 to 1.0 . The incidence of congenital malformations was higher in Wuzhou city and Yulin city, and lower in Beihai city. The incidence was 12.20%o in all city residents, and 11.55%o in villagers. But no significance was found between them. No significance was found either among the incidence of offspring from different maternal age group. In all types of congenital malformations the number of Bart’s syndrome was the most. The analysis of simple factor and multiple factors showed that main risk factors of congenital malformations included following: low birth-weight(OR=0.999), multiple pregnancy(OR=2.6), pregnancy complications (OR=3.2),exposure to chemical substances before or during pregnancy(OR=3.0), taking sedatives(OR=10.2), hormone drug(OR=9.4) and Chinese herb medicine(OR=2.5) during the early stage of pregnancy,low content of hemoglobin(OR=0.985), fathers’ exposure to noise(OR=5.7) or suffering from chronic diseases(OR=2.8). The risk of congenital malformations of offspring whose mothers’ blood type was AB, A, B was respectively three times, two times, one time more than that of offspring whose mothers’ blood type was type O. If mothers’ emotion was nervous and melancholy, their offspring’s risk was respectively two times, one time more than that of offspring whose mothers’ emotion was pleasant. If mothers’ occupation was workers and peasants , their offspring’s risk was respectively three times, two times more than that of offspring whose mothers’ occupation was staff,. No significance was found between staff and individual job. Conclusions: Enhancing pregnancy health care in high-risk group who having or exposing to above risk factors. Propagating extensively the knowledge of eugenics. Adjusting food composition. Avoiding taking some traditional Chinese medicine and western medicine that are harmful to pregnancy. Avoiding of exposure to some chemical substances. Keeping pleasant feeling. Risk factors that we have discovered deserve further research and will provide guidance reference for eugenics.更多还原