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目的探讨孕妇孕前体重指数(BMI)及相关因素与胎儿先天性心脏病(CHD)发病的关系。方法采用以医院为基础的病例对照研究及问卷调查方法,将2010年1月-2014年1月福建省妇幼保健院检查确诊CHD的186例孕妇作为病例组,以无任何先天畸形的正常孕妇286例作为对照组,根据孕妇BMI分为3组:体重过低组(BMI<18.5)、正常体重组(BMI=18.5~23.9)和体重超重组(BMI≥24.0)。结果单因素logistic回归分析结果显示,孕前BMI<18.5的孕妇胎儿患CHD风险增加(OR=1.59)。多因素逐步回归显示,孕前体重过低(BMI<18.5)、居住于农村、孕妇文化程度初中及以下、喝碳酸饮料、浓茶、存在先兆流产,其胎儿CHD风险增加;口服复合维生素和糖果巧克力是CHD的保护因素。结论重视管理育龄妇女孕前体重及饮食习惯,有助于预防和降低胎儿CHD的发病。
Objective To investigate the relationship between pre-pregnancy body mass index (BMI) and related factors and the incidence of fetal congenital heart disease (CHD). Methods Using hospital-based case-control study and questionnaire survey, 186 pregnant women diagnosed as CHD from January 2010 to January 2014 in Fujian Province were enrolled as case group and 286 normal pregnant women without any congenital malformation Cases as a control group, according to the pregnant women BMI were divided into 3 groups: underweight group (BMI <18.5), normal body weight group (BMI = 18.5 ~ 23.9) and overweight group (BMI≥24.0). Results The univariate logistic regression analysis showed that the risk of CHD was increased in fetuses with pre-pregnancy BMI <18.5 (OR = 1.59). Multi-factor regression showed that preterm low birth weight (BMI <18.5), living in rural areas, pregnant women with junior high school education and below, drinking carbonated drinks, tea, the risk of threatened abortion, the fetus CHD risk increased; oral multivitamins and candy chocolate Is a protective factor of CHD. Conclusions Emphasis on management of pre-pregnancy weight and eating habits of women of childbearing age will help prevent and reduce the incidence of fetal CHD.