先天性心脏病胎儿发病的孕前环境影响因素分析

Analysis of Pre Pregnancy Environmental Factors Influencing the Incidence of Congenital Heart Defects in the Fetus

摘要:

〔摘 要〕 目的：分析先天性心脏病胎儿发病的孕前环境影响因素。 方法：选取 2020 年 1 月至 2022 年 8 月在新乡市妇 幼保健院行超声检查并确诊为先天性心脏病的 73 例胎儿为观察组，选取同期行超声检查的健康胎儿 73 例为对照组。比较 两组孕妇及胎儿的一般资料及孕前环境暴露情况，并以二元 logistic 回归筛选出独立性影响因素。 结果：两组孕妇孕前重金 属暴露、有毒化学品接触、强辐射环境工作、工作环境嘈杂及被动吸烟情况比较，差异具有统计学意义（P ＜ 0.05）；两 组孕妇年龄、受教育程度、孕次、产次比较，差异无统计学意义（P ＞ 0.05）。多因素 logistic 回归结果显示，重金属暴露、 有毒化学品接触及强辐射环境工作为胎儿先天性心脏病的独立性危险因素（OR ＞ 1，P ＜ 0.05）。 结论：孕妇孕前重金属 暴露、有毒化学品接触、强辐射环境等环境因素暴露均与胎儿先天性心脏病的发生密切相关，临床应指导备孕的妇女避免 在上述环境中暴露以降低胎儿先天性心脏病的发生风险。

Abstract:

〔Abstract〕 Objective To analyze the influence factors of pre pregnancy environmental on the incidence of fetal congenital heart defect. Methods From January 2020 to August 2022, 73 fetuses with congenital heart defect diagnosed by ultrasound in Xinxiang Maternal and Child Health Hospital were selected as the observation group, and 73 healthy fetuses with ultrasound in the same period were selected as the control group.Compare the general information and pre pregnancy environmental exposure of two groups of pregnant women and fetuses, and screen for independent influencing factors using binary logistic regression. Results There was a statistically significant difference between the two groups of pregnant women in their exposure to heavy metals, exposure to toxic chemicals, working in high radiation environments, noisy work environments, and passive smoking before pregnancy (P < 0.05); There was no statistically significant difference (P > 0.05) between the two groups of pregnant women in terms of age, education level, gestational age, and parity. The results of multivariate logistic regression showed that heavy metal exposure, exposure to toxic chemicals, and working in high radiation environments were independent risk factors for fetal congenital heart disease (OR > 1, P < 0.05). Conclusion Pre pregnancy exposure to heavy metals, toxic chemicals, strong radiation environment and other environmental factors are closely related to the occurrence of fetal congenital heart defect. Clinical guidance should be given to pregnant women to avoid exposure in the above environment to reduce the risk of fetal congenital heart defect.